Eptisam Mohammed

ADDIS ABABA UNIVERSITY
SCHOOL OF INFORMATION SCIENCE

And
School of Public Health
M.Scin Health Informatics Program
Web- Based Medical Equipment Information Management

System, The Case of Dire Dawa Administration Health Bureau
By
Eptisam Mohammed
Jun/2015
Addis Ababa, Ethiopia

SCHOOL OF INFORMATION SCIENCE
And
School of Public Health
M.Sc in Health Informatics Program

A Project Submitted to the School of Information Science and

Public Health of Addis Ababa University in Partial Fulfillment
of the Requirement for Degree of Master of Science in Health
Informatics
By
Eptisam Mohammed
Jun/2015
Addis Ababa, Ethiopia

SCHOOL OF INFORMATION SCIENCE AND
SCHOOL OF PUBLIC HEALTH

By
Eptisam Mohammed
Name and Signature of Members of the Examining Board

__________________________________________________________
Examiner Signature Date
Examiner Signature Date
Advisor Signature Date
Advisor Signature Date

ACKNOWLEDGEMENT
I would like to thank Addis Ababa University school of Information Science and
school of Public Health for providing me this opportunity. My special heartfelt
thanks go to my advisers Ato Ermias Abebe and Dr. Negusse Deyessa for their
patience, encouragement, stimulating advices, and constructive suggestions, who
helped me to pass through all the challenges and complete my project. A special
thanks to Mesert Ayaneo for her kind and precious help on the administrative part.
I would like to pass my special thanks to my friends Free Amde and Mahdi
Abdella for the information and supports they provide me, all the time I need, and
all my staffs who support me and initiate me to join this study program. My special
appreciations go to the staff of the Biomedical Department specially Ato Anteneh
Berhanu for providing me all the necessary information.
Last but not least, I would like to pass my sincere gratitude to my beloved family,
specially my mother who provides me special support and her limitless love.
Table of Contents
Contents Page
ACKNOWLEDGEMENT ................................................................................................... i
Table of Contents ................................................................................................................ ii
List of Tables ...................................................................................................................... ii
List of Figures ..................................................................................................................... ii
List of Use Cases ................................................................................................................ ii
List of User Interface Prototype .......................................................................................... ii
List of Figures ..................................................................................................................... ii
Acronyms ............................................................................................................................ ii
Abstract ............................................................................................................................ ix
Chapter One
1.Introduction ...................................................................................................................... 1
1.1.Background ................................................................................................................... 1
1.2.Statement of the Problem .............................................................................................. 3
1.3.Objective of the project ................................................................................................. 5
1.3.1.General Objective ...................................................................................................... 5
1.3.2.Specific Objective ...................................................................................................... 5
1.4.Significance of the Project ............................................................................................ 6
1.5.Scope of the project ...................................................................................................... 7
Chapter Two
2.Literature Review............................................................................................................. 8
2.1Medical Equipment and Medical Equipment Information ........................................... 8
2.1.1.Medical equipment..................................................................................................... 8
2.1.2.Medical Equipment Information Management System ......................................... 8
2.1.3.Information System Management .............................................................................. 9
2.2.System Development Methods, Tools, and Techniques ........................................ 10
2.2.1.Information System Development ......................................................................... 10
2.2.2.Modeling Method..................................................................................................... 10
2.2.3.Techniques ............................................................................................................... 11
2.2.3.1.Use Case Diagram................................................................................................. 11
ii
2.2.3.2.Activity Diagram .................................................................................................. 12
2.2.3.3.Class Diagram ....................................................................................................... 12
2.2.3.4.Sequence Diagram ................................................................................................ 12
2.2.4.Process Model .......................................................................................................... 13
2.2.5.Web based System Development........................................................................... 13
2.3.Related Works ............................................................................................................. 14
2.3.1.An Equipment Maintenance system ........................................................................ 14
2.3.2.KALMAN Equipment Management System (KEMS) ........................................... 15
2.3.3.POC-Link ................................................................................................................. 15
2.3.4.Management Information System of Medical Equipment using Mobile Devices ... 15
2.3.5.Medical Equipment Management System (MEMS) ................................................ 16
2.3.6.AIMES ..................................................................................................................... 16
2.3.7.PRAXIS ................................................................................................................... 17
2.3.8.EMIS for Fleet Management ................................................................................ 17
2.3.9.ECRI-AIMS Hospital Equipment Management System ....................................... 17
2.3.10.PTI/APWA Equipment Management Information System ................................. 18
2.3.11Medical Equipment Workflow Management System ............................................. 18
Chapter Three
3.Methodology .................................................................................................................. 19
3.1.Study Area .................................................................................................................. 19
3.2.Study Design .............................................................................................................. 19
3.3.Study Population ........................................................................................................ 19
3.4.Sampling Method ....................................................................................................... 20
3.5.Data Collection Procedure ......................................................................................... 20
3.6.Data Analysis Procedure ............................................................................................. 20
3.7.Date Quality Management ........................................................................................ 20
3.8.Implementation ........................................................................................................... 20
iii
3.9.Operational Definitions ............................................................................................... 21
3.10.Ethical Clearance ...................................................................................................... 21
Chapter Four
4.Discussion of Result .................................................................................................... 22
4.1.Introduction ................................................................................................................. 22
4.2.System Analysis .......................................................................................................... 22
4.2.1.Current System......................................................................................................... 22
4.2.1.1.Hardware ............................................................................................................... 22
4.2.1.2.Software ................................................................................................................ 23
4.2.1.3.Network................................................................................................................. 24
4.2.1.4.People.................................................................................................................... 24
4.2.1.5.Data / Process ........................................................................................................ 24
4.2.1.6.Procedure .............................................................................................................. 25
4.2.1.7.Management .......................................................................................................... 25
4.2.1.7.1.Vision of the Department ................................................................................. 25
4.2.1.7.2.Mission of the Department............................................................................... 25
4.2.1.7.3.Responsibility of the Department ................................................................... 25
4.2.1.7.4.Job Description of the Professionals ............................................................... 25
4.2.1.7.5.Communication .................................................................................................. 26
4.2.2.Proposed System ...................................................................................................... 27
4.2.2.1.Context Diagram for the New MEIMS ............................................................ 28

4.2.3.Stakeholders ............................................................................................................. 29
4.2.4.System Analysis Models ......................................................................................... 30
4.2.4.1.Use Case Diagram................................................................................................. 30

4.2.4.2.Use Case Narrations .............................................................................................. 32
4.2.4.3.Activity Diagram Modeling ................................................................................ 32
4.2.User Interface Prototype ............................................................................................. 35
4.2.5.System Requirements............................................................................................... 36
iv
4.2.5.1.Functional Requirements ...................................................................................... 36
4.2.5.2.Non functional Requirement ................................................................................. 38
4.3.System Design Models ............................................................................................... 39
4.3.1.System Class Diagram ............................................................................................. 39
4.3.2.Sequence Diagrams .................................................................................................. 41
4.3.3.System Architecture ................................................................................................. 42
4.4.Prototype Implementation .......................................................................................... 44
4.4.1.Presentation Layer .................................................................................................. 44
4.4.1.1.Medical Equipment Registry Form ..................................................................... 44

4.4.1.2. Usability Testing for User Interface ................................................................ 45
4.4.2.Database Layer........................................................................................................ 46
4.4.2.1. Database Model ................................................................................................... 46

4.4.2.2. Physical Storage ................................................................................................. 46
4.4.3.Middle Layer ........................................................................................................... 49
Chapter Five
5.Conclusions And Recommendations ........................................................................... 50
5.1.Conclusions ................................................................................................................. 50
5.2.Recommendations ....................................................................................................... 51
Reference ......................................................................................................................... 53
Appendix A Software Requirement Specification Document .......................................... 56
Appendix B: Requirements Collection Check List ......................................................... 106
Appendix C: User interface Usability Testing Checklist ................................................ 111
v
List of Tables
Table 4.1: Hardware Inventory of the Existing System ................................................. 23

Table 4.2: List of stakeholders and their roles and responsibilities ........................... 29
Table 4.3: Functional requirement list .............................................................................. 36
Table 4.4: Non Functional requirement list .................................................................... 38
Table 4.5: User Interface Test Result ........................................................................... 45
List of Figures
Figure 4.3:System Use Case Diagram for Medical Equipment Information .................... 31
Figure 4.2:Context diagram for Medical Equipment Information Management System 28
Figure 4.1:The Organizational Structure Of Dire Dawa Administrative ......................... 26
Figure 4.4:Activity diagram for medical equipment registering process ......................... 34
Figure 4.5:Class Diagram for Medical Equipment Information Management System .... 40
Figure 4.6:Sequence diagram for the process of registering medical ........................ 41
Figure 4.7:MEIMS Architecture ....................................................................................... 43
Figure 4.8:Medical Equipment Registry Form ............................................................... 44
Figure 4.9: Overall storage tables and their relationships to each other ..................... 47
Figure 4.10:The physical Database Model of MEIMS ................................................. 48
Figure 4.10:Sample of PHP Cods .................................................................................. 49
List of Use Cases
Use Case ID: UC-03 ......................................................................................................... 33
List of User Interfaces
User Interface Prototype ID: UIP-03 ................................................................................ 35
vi
Acronyms
AMT Active Management Technology
BPR Business Process Reengineering
CASE Computer Aided System Engineering
CED Clinical Engineering Department
CM Corrective Maintenance
CRCP Curative and Rehabilitative Core Process
DFD Data Flow Diagram
DPCP Disease Prevention Core Process
EFY Ethiopian Fiscal Year
EMIS Equipment Management Information System
FDA Food and Drug Administration
FMoH Federal Ministry of Health
GHTF Global Harmonization Task Force
HR Human Resource
HSDP Health Sector Development Program
HTML Hyper Text Markup Language
ISD Information System Development
ITEA Information Technology for European Advancement
KEMS KALMAN Equipment Management System
MEIMS Medical Equipment Information Management System
MEMS Medical Equipment Management System
MySQL My Structured Query Language
OO Object Oriented
vii
PFSA Pharmaceutical Fund and Supply Agency
PHS Peripheral Health Care
POC Point Of Care
RHB Regional Health Organization
SDLC System Development Life Cycle
PM Preventive Maintenance
UC Use Case
UIP User Interface Prototype
UI User Interface
UML Unified Modeling Language
WHO World Health Organization
viii
Abstract
Background: In delivering the health care service, health professionals use different
kinds of medical equipment to provide quality health care service. Medical equipment
is any instrument, apparatus, machine, appliance, implant, in vitro reagent or
calibrator, software, material or other similar or related article which does not achieve
its primary intended action in or on the human body by pharmacological, immunological or
metabolic means. Medical equipment information management system is used to
automate the documentation of all activities relating to medical equipment.
Objective: The objective of this project is to design web- based information system
for medical equipment management taking the Dire Dawa administration health bureau
as a case.
Methodology: This project is conducted in Dire Dawa administration health bureau for
the biomedical case team. This project follows the design science methodology.
Object Oriented analysis and design methodology is used for requirement analysis
and design. Purposive sampling was used to find the study area. In depth interview and
document review were done to analyze the existing situation. UML techniques were
used to model the analysis and design of the new proposed system. The investigator
uses HTML, PHP and MySQL to design system prototype.
Discussion Of Result: The use case diagram identifies all the process and system
boundary of the proposed system. Eleven processes were identified with their
corresponding actors. Fourteen objects of the system were identified and modeled
using the class diagram. The flow and sequence of the processes were presented
using the sequence diagrams. User prototype was modeled for the system usability
testing.
Conclusion: This project does not show the final product of the system, rather
provides system prototype for further continuous evaluation and development along
with the user feedback input. In addition to the system prototype, the project
identifies the points need to be improved and the areas need further investigation in
the existing system.
ix
Chapter One
1. Introduction
1.1. Background
Dire Dawa administrative city is found in the eastern part of Ethiopia. It is 517
km away from the capital city Addis Ababa. The population of Dire Dawa is
around 400,000.
The Dire Dawa administration health bureau has four core processes and two
supportive processes. The core processes are Disease Prevention, Curative and
Rehabilitative, Regulatory, and Plan and program core processes. The supportive
processes are Human Resource and Finance.
According to the definition by the Global Harmonization Task Force (GHTF),
“medical device is any instrument, apparatus, implement, machine, appliance,
implant, in vitro reagent or calibrator, software, material or other similar or
related article which does not achieve its primary intended action in or on the human
body by pharmacological, immunological or metabolic means, but which may be
assisted in its intended function by such means”(1).
Medical equipment is part of medical device which needs calibrating, maintaining,
repairing, and decommissioning. It excludes implantable, disposable or single use
medical devices(2).
Health facilities provide a variety of health care services depending on the level of
the facility. In delivering the health care service, health professionals use different
kinds of medical equipment to provide quality health care service. “Medical
equipment is crucial in the prevention, diagnosis and treatment of illness and
disease, as well as patient rehabilitation”(3).
In health facilities wide variety of medical devices are being used, which may
range from simple tools used during medical examination like a thermometer, or
high complex lifesaving medical devices like heart valves and coronary stents.
1
According to the standard set by the Federal Ministry of Health (FMoH) of
Ethiopia, primary hospitals, health centers and health posts should be equipped
with 180, 150, and 120 different types of medical equipment respectively at a
minimum(4).
The Biomedical department or clinical engineering department of health bureau is
responsible for including and excluding medical equipment in the health
technology management program for tests, repairs and maintenance. Appropriate
management of medical equipment ensures safe and effective health service
provision (5).
Medical equipment information management system (MEIMS) is used to automate
the documentation of all activities relating to medical equipment and provide report
and notification message for planned maintenance(6).
As WHO medical device technical series in 2011 stipulate, MEIMS incorporates
equipment and spare parts inventory modules, preventive and corrective maintenance
module, and contracts management module(3). The analyzed records of these
modules can be used for the technology management, quality assurance, work order
control and budgeting of medical equipment.
As a result of a critical examination of the nature, magnitude and root causes of the
prevailing health problems of the country, the transitional government of Ethiopia
had issued its health policy in September, 19931. One policy priority is that the
“provision of essential medicines, medical supply and equipment shall be
strengthened, and among the strategies that had been issued to assure the
availability of drugs, supplies and equipment were the listing of essential and
standard drugs and equipment, and updating such lists, encouraging national
production capability of drugs and equipment, and developing maintenance and
repairing facilities for equipment” (7).
Therefore, a medical equipment information management system is an essential
component in implementing the government health strategy.
1
Note: Years indicated in this project report are in Gregorian calendar except where it is indicated
otherwise.
2
1.2. Statement of the Problem
Medical devices can cause a serious problem for users and patients, if they are
not well managed during health care service provision. Food and Drug
Administration (FDA) agency of the United States in 2006 reported 116,086 device
related injuries, 2,830 deaths and 96,485 malfunctions of device (8). This shows,
that the poor use or mismanagement of medical equipment has an effect on the
health care service quality. Therefore, it is important to have documentation and
reporting system to identify and solve medical equipment related problems in a
given health care organization.
In a study done by the department of Mechanical Engineering, Laval University in
Canada, it is found that 32.2% medical equipment repair calls made due to
equipment management issues and 13.7% is related to inadequate preventive
maintenance for the equipment, setup and uncategorized calls (9).
From this study, we can understand that the lack of medical equipment
management can cause a failure of the equipment which results in repeated repair
calls and increase in the cost of maintenance. On the other hand, if medical
equipment information management system is put in place, it can help to
implement a planned preventive maintenance for the equipment and reduces cost by
providing adequate and proper information about the equipment being used.
The research done over maintenance management of medical equipment in major
hospitals of Kenya reported that, the responsible public organization on
maintenance does not have proper management of medical equipment (10). The
problem identified in Kenya is also experienced by our country.
A research done relation to this, in Ethiopia shows that the lack of equipment
management is the source for equipment failure. Further, newly acquired equipment
lie idle. The essential ingredients missing in the majority of research institutes and
universities in Ethiopia are the organizational structure and functioning system that
create enabling situations for scientific equipment and technology management
through their lifecycle. It is recommended to create an enabling scientific
3
equipment management system for these institutes. These problems of equipment
management are also shared by the health institutes found in the country (11).
The cost of medical devices globally as well as nationally is very high. In 2006
global market figure of medical device was expected to exceed US$260
billion(12). Nationally, from the Health Sector Development Program (HSDP)
quarterly health bulletin report in April 2014, the Pharmaceutical Fund and Supply
Agency (PFSA) has distributed pharmaceuticals and medical equipment worth ETB
8.19 billion in 2005EFY (13).
In Ethiopia, the lack of proper management of medical equipment has limited the
capacity of health institutions to deliver adequate health care. It is estimated that only
about 61% of medical equipment found in Ethiopian public hospitals and other health
facilities are functional at any one time (14).
As the information gained from the head of the biomedical case team of Dire
Dawa city Administration health bureau indicates, there are problems associated
with the management and information availability on medical equipment. As health
care delivery continues to expand and improve in the region and an increasing
number of sophisticated medical equipment is introduced, a system capable of
supporting and managing the medical technology must be put in place.
The intention of this project is therefore, to develop medical equipment
information management system that may help the region to be more efficient and
effective in managing the maintenance and use of medical equipment so as to
provide a reliable and quality health care service.
4
1.3. Objective of the project
1.3.1. General Objective

The general objective of this project is to design a web- based information system
for medical equipment management, taking the Dire Dawa administration health
bureau as a case.
1.3.2. Specific Objective

The specific objectives are to
- Identify user and system requirements of medical equipment information
management system for Dire Dawa administration health bureau;
- Analyze the system requirements identified;
- Design system model of the medical equipment information management
system;
- Design general (high level) system architecture of the medical equipment
information management system;
- Test user interface prototype model of the system;
- Develop a prototype of the medical equipment management information
system to demonstrate its potentials;
5
1.4. Significance of the Project
The new medical equipment information management system will hopefully

provide different functionalities for different individuals.
Users and health professionals
- The system makes their work easier, effective, and efficient.
- It helps them in tracing and controlling the performance of a specific
medical equipment.
- It helps the health professionals in providing quality health care service.
Patient
- Make them to conserve save, accurate and quality health care service.
- Reduce the risk of medical equipment accident on the patients.
Administrative Health Bureau
- It helps to have the general future of medical equipment inventory
information about the region.
- It helps in the procurement planning of medical equipment.
- It helps to identify the gaps of medical equipment management and set
solution.
- Help in resource allocation for medical equipment management and
controlling activities.
- Provide system prototype ready for implementation
Other student / Researcher
- Provides complete information of medical equipment for study and research
purpose.
- It can be used as starting point for other related projects.
.
6
1.5. Scope of the project
This project is limited to the design of a web based medical equipment

information management system and a system prototype thereafter. The project
does not present a complete outstanding system rather it provides a first blueprint
of the initial system development iteration process output. It also includes the
initial user interface prototype testing. This project is implemented for Dire Dawa
Administrative Health Bureau biomedical case team and three health facilities,
Dilchora hospital, Sabiyan primary hospital, and Gendkore health center as a pilot.
The medical equipment included in the management information system are those
instruments, apparatus, machine, calibrator, materials and vitro reagent used for
prevention, diagnosis, treatment and rehabilitation service provision for a patent,
excluding implantable, disposable or single use medical equipment. The project
executed in the duration of Jan, 2015 up to May, 2015. The project uses an
Object Oriented methodology as modeling method and the iterative process
modeling as a process of analyzing and designing the system. The technique used
in this system analysis and design are UML modeling techniques. To present the
UML models and the user interfaces prototype of the system Visio and White Star
CASE tools are used. PHP, HTML programming language and MySQL database
management system are used to implement the system software prototype. The
system architectural design is presented using three tire client server system
architecture. The hardware requirement and network design are not included in this
project.
7
Chapter Two
2. Literature Review
2.1. Medical Equipment and Medical Equipment Information
Management System
2.1.1. Medical equipment
To complete the diagnoses and treatment for patient with care, the medical
environment is highly dependent on various types of medical equipment.
“Medical equipment is any instrument, apparatus, implement, machine, appliance,
implant, in vitro reagent or calibrator, software, material or other similar or related
article which does not achieve its primary intended action in or on the human
body by pharmacological, immunological or metabolic means, but which may be
assisted in its intended function by such means”(15). It excludes implantable,
disposable or single use medical devices (16).
Medical equipment must be kept in good condition to prevent from injuries
occurred in patient as well as in users. Moreover, to compete with the dynamic
environment and complex health care system, health institutions should take the
appropriate cost controls in response to that situation(17).
The biomedical engineering unit in health institution is responsible for the patient
and clinical staff safety in using medical devices. In addition to the cost control
in related operational activities of a medical device, such as purchase, contract,
repair, and maintenance, is another important job for this unit. (18)
2.1.2. Medical Equipment Information Management System
MEIMS is a system that deals with the management of medical equipment
information, for the purpose of supporting health care technology management in
making the equipment used safely and effectively. MEIMS incorporates equipment
and spare part inventory modules, maintenance module, and contracts management
module (3).
Each module has its own information table. Equipment inventory module contains
manufacturer information, location and all fields necessary for effective health
technology management are included. The module help to record equipment
8
information using the equipment code given to a specific device. The spare part
inventory module tracks the spare part related to the equipment. It helps to
manage the stock level and report on the consumption of reused parts. The two
main parts of maintenance module are the planned preventive maintenance, which
helps the user in calculating when a piece of equipment will require maintenance.
The second part is the corrective maintenance, which helps in generating a work
order for the specific equipment maintenance request and capture all information
on maintenance. The contract management module is used to track all externally
provided maintenance services (3).
MEIMS provides an advantage of automated preventive triggers, easy auditing
process, reporting, centralize database, real time information, and communication
among responsible staffs. It enables to track the status of maintenance work on
items and the associated costs of that work in one system. MEIMS can be
designed in the way it suits with the interested institute. This system commonly
has a different nomenclature in different places like, Enterprise Asset Management
software, Maintenance Management software, Work Order Software, Work Order
Management Software, Facility maintenance software and so on (19).
2.1.3. Information System Management

The information system is a transformation of data consists of basic fact into an
output that is valuable to users. It is the collection of technical and management
resources that provide the storage, computing distribution, and communication for
the information required by all or any part of an enterprise. Information system
management is the application of information technology to support the major
function and activities of the institution. It uses to solve business problems and
the management of technology.
9
2.2. System Development Methods, Tools, and Techniques
2.2.1. Information System Development
Information system development(ISD) is steps taken to change object system in a
specific environment using a different group of tools and an organized collection of
techniques. Which is in general called method. ISD is expected to include manual
and computerized parts of an object system. (20). In addition to the techniques and
tools, a developer can use the different process model and modeling methods in
the development process of an information system.
2.2.2. Modeling Method

Modeling is a way of depicting the existing business domain in understandable
system concept. It also shows the benefits of abstracting complex system to model
form. Different system developers can use different modeling methods like,
Traditional, structured and Object Oriented modeling methodology.
Structured analysis and design are process centered approach that transform data
into useful information. It uses a series of phases, systems development life cycle
(SDLC), to plan, analyze, design, and implement (21).
In an object oriented analysis and design, it describes the real world of its
objects, the attributes, operations, and relationships. It is the object perspective of
the problem domain. In contrast with the structured modeling, object oriented
modeling combines data and processes that act on the data into things called
objects. Its flexible, efficient, scalable and easy transition to OO programming
languages make it popular in an information system development ( 21).
The Object Oriented approach uses the inheritance principle that increases the
advantage of reusability of functions and introduces standardized ways of
performing basically similar functions on the data. This principle of OO is
contradicts with the principle of design used by the structured approach (22).
10
2.2.3. Techniques
Technique mean a set of steps and a set of rules which define how a
representation of an information system is derived and handled using some
conceptual structure and related notation. Object Oriented analysis and design use
static and dynamic UML (Unified Modeling Language) techniques to visualize and
document an information system. UML models are used to show the analysis and
design of an information system in a different modeling diagram like, Use Case,
Activity, Class and Sequence diagrams (21).
Data Flow Diagram (DFD) is a technique used to show the business process and
the data that pass among them. If focus mainly on the process or activities that
are performed(21). From this point it is clear that DFD more goes with structural
system analysis and design approach.
CASE is a Computer Aided System Engineering tool which uses to simulate and
draw different models for the system to be developed. It visualizes the blueprint
of the system for the users and make them evaluate and give feedback easily.
This tool is important in helping the developer to identify the gaps of the system
as early as possible. It makes life easy for the developer because it is easy to edit
it repeatedly. There are different tools available for modeling diagram like, Visio,
Ambrello, and White Star (21). In contrast with the other tools, Visio uses to draw
the modeling diagrams as well as the user interface prototype, where the only
other use for modeling diagram.
2.2.3.1. Use Case Diagram
An accepted way of accomplishing functional requirement of system is the use case
analysis. Use case analysis is a case based way of describing the uses of the
system with the goal of defining and documenting the system requirement. It is a
powerful technique that describes the kind of functionality that a user expects
from the system. It does this by defining a number of actors, which model the
roles that users can play when interacting with the system, and describing the use
case that those actors can participate in.
A use case diagram is a visual summary of several related use cases within a
system or subsystem. It shows the system boundary clearly and what is included
11
in the system. The description of each use case shown within the use case diagram
can also be presented in a narrative form. The use case description documents
the name of the use case, the actor, description of the use case, a step by step list
of the tasks and action required for successful completion, a descriptive course of
action, preconditions, post condition, and business rule.
2.2.3.2. Activity Diagram
An activity diagram is a flow chart that shows the actions and events as they
occur. They show the order in which the actions take place and identify the
outcomes. Activity diagrams are dynamic modeling tools that can help a system
analyst understand how objects behave and interact with the system.
2.2.3.3. Class Diagram
A class diagram represents a detailed view of a single use case, shows the class
that participate in the use case, and documents the relationship among the classes.
It is logical model, which evolves into a physical model and finally become a
functioning information system(21). A class diagram is a static model of system,
describe the structural relationships that hold between the pieces of data
manipulated by the system. They describe how data is parceled out into objects,
how those objects are categorized, and what relationship can hold between them.
They do not describe the behavior of the system, nor how the data in a system
evolve over time.
2.2.3.4. Sequence Diagram
Sequence Diagram is used primarily to show the interactions between objects in
the sequential order as those interactions occur. A business level sequence diagram
can be used as a requirement document to communicate requirements for a future
system implementation. The other primary uses of the diagram are in the transition
from requirements expressed as use cases to the next and more formal level of
refinement.
12
2.2.4. Process Model
It is the type of model that shows how a system analysis and design phases
proceeding in a system development process. Among different types of process
models the one is an iterative life cycle model. “This model does not attempt to
start with a full specification of requirements. Instead, development begins by
specifying and implementing just part of the software, which can then be reviewed
in order to identify further requirements”(23). This process is then repeated,
producing a new version of the software for each cycle of the model. In working
iteratively, creating a rough product or product piece in one iteration, then review
it and improve it in the next iteration and so on until it’s finished. It is building
and improving the product step by step so that it is possible to track the defect at
an early stage. This avoids the downward flow of the defects. In this model it is
easy to get the reliable user feedback. In the iterative model less time is spent on
documenting and more time is given for designing (23).
A waterfall process model is simple to understand and use. In this process model
each phase processed one after another, do not overlap. In this case the system
does not tested unless it is developed completely, which reduces the usability of
the system (24).
2.2.5. Web based System Development

Internet based system is a series of web pages that provides a user interface,
which communicates with one or more levels of data management software and
web based database server. A web base system developed and delivered in an
internet based framework. This type of system is easily scalable and can run on
multiple hardware environments.(21). Developing a web based system, HTML is a
language for describing web pages. It stands for Hyper Text Markup Language.
HTML codes are used to tell the browser how to display a text, image, and all
things need to be displayed on the web page. In a web based system the
database of the system needs to be connected with the web page, through which
data can be accessed from the database using a web browser. To connect the
database to the web, it is necessary to use middleware. A middleware can
13
interpret client requests in HTML form and translate the requests in HTML form
and translate the requests into commands that the database can execute (21).
There are different language used to state the middleware process like PHP. PHP
is a server side language that allows to embed little programs into the HTML
code of a webpage. It gives greater control over what appears in the browser
window than HTML alone can provide. PHP-scripts are interpreted by the web
server alone, which enable the user to use different type of browser without
worrying about language compatibility. The other part in web based system
development is the database management. MySQL is the most popular free
database engine available today, which supports the standard language of SQL
uses to interact with relational database (25).
2.3. Related Works

The medical equipment management information system is used for equipment
inventory, a work order system, the preventive maintenance schedules/procedures,
outsourcing contract management and all service history records. And also, it is an
administrative tool to track equipment, to initiate work orders, to obtain performance
indicators, to determine equipment failure trends, to identify training needs, and to
produce management reports.
2.3.1. An Equipment Maintenance system

An equipment maintenance system used to maintain equipment master file using
magnetic files. It is developed for the industries in Johannesburg. The system
contains capital cost data, date of installation, summarized history information like
maintenance cost, breakdown frequencies, maintenance work done, and
maintenance spare part used for each item. Information stored in this system
using punched paper tape or cards. The system provides monthly reports as an
output and planned maintenance schedule (26 ).
14
2.3.2. KALMAN Equipment Management System (KEMS)
KEMS is designed based on the success of the Vista Asset Management (VAM)
solution. It is used by the department of defense agencies in the US. This system
is a web base information system that provides real time information on the
quantity, specific location, readiness status, and life cycle history of all equipment.
The software is provided using an internet browser interface which is paired with
share point and SQL. It captures critical information like start and stop time,
material consumption, maintenance cost, calibration information and preventive
maintenance schedules, and tracks item warranties expiry date (27).
2.3.3. POC-Link
In managing computerized medical equipment, Intel provides Intel vPro
technology, including Active Management Technology (AMT). They can manage
from a central location by using 3G to connect them to the internet. Advantech
company released the POC-W211 point of care terminal which can be integrated
with Intel AMT technology. POC-Link software is a remote computer management
system based on client/server architecture. It works on POC (Point Of Care)
devices with remote monitoring and management capabilities for critical managed
items. This software allows biomedical staff to configure, deploy, manage,
monitor, diagnose and maintain distributed POC terminals remotely irrespective of
their location (28).
2.3.4. Management Information System of Medical Equipment using

Mobile Devices
This information system uses a mobile device as central axis of the system. It
also uses Qr-codes (2D barcodes) which are decoded to receive on the mobile
device critical information about the equipment. Through a web server connectivity
the mobile platform uses to generate a service order for the maintenance of
biomedical equipment. The main tools used to develop this information system;
Java to develop cell phone software due to its compatibility with the device, 2.0
15
MP integrated camera for capturing of the barcodes of the equipment and
GPRS/EDGE connectivity. It also uses Apache web server with PHP and MySQL
programming language for the database development.(29).
2.3.5. Medical Equipment Management System (MEMS)
MEMS, designed to manage equipment inventory, work order system, the
preventive maintenance schedule, outsourcing contract management and all service
history records. The system is developed for in-house Clinical Engineering
Department (CED). It is integrated with the health information system of the
National Taiwan University Hospital. The web pages of MEMS were designed
using Visual studio C#. The web server of CED designed by Front-page and
Dream Weaver. To develop the database, they have used Microsoft SQL server and
Oracle database (30).
2.3.6. AIMES
Europe is developing a fully integrated approach which reduces manual process,
errors, and improve quality with modern electronic business processes for suppliers
and hospital on medical equipment management. The project result of AIMES,
ITEA2 in Europe shows, the development of logistic management of medical
equipment, including inventory control, tracking and dynamic scheduling, medical
equipment maintenance, and development of adaptable user interface depending on
the specific task. In the project technological advance, there was an end to end
problem solving in the hospital based on standard smart phone by the device
manufacture’s service technician online. Integration between hospital and
manufacturers using web service technology was implemented by the project, to
make hospital access a device directly and obtain its status. Generally, this project
can shows us how an information technology advance the medical equipment
management system as whole (31).
16
2.3.7. PRAXIS
PRAXIS is an in-house developed computerized medical equipment management
system. This software is used to enter and store data using relational database. It
is networked with different work stations, which allows different user to enter
data at the same database. Web-PRAXIS system implemented for the purpose of
web-based application and service, centralized database management and support of
an application upgrade and data update. WEB-PRAXIS is developed using PHP open
source code, which is able to work with Oracle or MySQL (32).
2.3.8. EMIS for Fleet Management

Equipment management Information system (EMIS) is a computer based system
that maintains data on motor vehicles owned by Florida state agencies, including
car, truck, vans, heavy equipment, and watercraft. EMIS is an old computer
application and operates on a mainframe computer system which makes it
expensive. The OPPAGA of the state reported that, even though most of the
Florida agencies were not satisfied with the performance of equipment EMIS,
Three largest agencies were generally satisfied and helps them to control 60% of
the motor vehicles within the agencies. The main complaint of the agencies were
difficult to use, did not provide needed information, produce outdated reports and
staff were reluctant to use EMIS’s report believing that the data were inaccurate
and unreliable. The EMIS was decided to be redesigned to meet the needs of
state agencies (33).
2.3.9. ECRI-AIMS Hospital Equipment Management System

It is web-browser application for managing all aspects of technology based assets
in hospitals. In the system, data of the equipment stored centrally in which can be
accessed through the hospital intranet. The client uses browser to access central
data, there is no software need to be installed on the client side. To develop the
central database management system they have used standard Microsoft SQL
server database. The system includes six basic system component; equipment,
work order, data managers, Administration, customer service, and report. It helps
17
to manage equipment inventory, work order, service control, spare part, purchasing,
and stock control. (34).
2.3.10. PTI/APWA Equipment Management Information System
The public technology Information system group were implementing a computer
based information system called PTI/APWA equipment management information
system, which helps an equipment manager to understand equipment cost,
maintenance characteristics, and equipment performance. The software maintains
records for the vehicles utilized by various organizational units. It is all about set
of computer programs, worksheets, and forms. The system generates a series of
reports monthly and some reports are generated only when requested ( 35).
2.3.11. Medical Equipment Workflow Management System

Medical equipment, workflow management system was developed to be a helpful
tool in asset control and workflow management for the medical device service
providers. The system designed in three main modules for its’ standard system
installation. The three main are equipment inventory, preventive maintenance, and
corrective maintenance/repair module. The system contributes benefits of electronic
document workflow, work records management, remote access dynamic web
application, modular structure, simple software interface, and electronic preventative
maintenance checklists. (36)
In general, the above literatures can teach us to what extent an equipment
management systems are being implemented. It shows how an equipment can be
managed and controlled using different technology in different level, place and
time. It also helps us to identify the success and the failure point of a system,
What an equipment management system should include, and how a medical
equipment management system could be improved over time.
18
Chapter Three
3. Methodology
3.1. Study Area

The project is implemented in Dire Dawa administration, health bureau for the
biomedical case team. Dire Dawa administration, health bureau incorporates two
hospitals (one referral hospital and one primary hospital), fifteen health centers and
thirty one health posts. The medical case team of the bureau was set up in 2005
during the implementation of BPR at regional level. The team has two biomedical
technicians and two biomedical engineers. The aim of the case team was to
provide maintenance service for biomedical equipment on all public health facilities
in the region. From the paper based inventory made in 2011, it is reported the
total medical equipment available in the public health facilities of the region was
about 270 in number and 44 in type. And their cost was estimated to be about 14
million Ethiopian Birr. And it’s possible to estimate to what extent will increase
the number of the medical equipment and its’ corresponding cost with the
improvement of health care service.
3.2. Study Design

The project is conducted from Jan to May 2015. This project follows the design
science methodology, which is the knowledge of using techniques, methods,
models, and theory for creating artifacts that satisfy given sets of functional
requirement. Object Oriented analysis and design methodology is used for
requirement analysis and design. This methodology makes the process of
developing system more flexible, easily maintainable and scalable. It also
supports the use of an iterative process model which helps to improve the system
step by step in a cyclic way until it satisfies the users.
3.3. Study Population

The situational analysis was conducted with all relevant experts of the biomedical
equipment case team.
19
3.4. Sampling Method
The project was done on Dire Dawa Regional Health Bureau, which makes it
purposive in finding the area of the project, where the situational analysis was
done.
3.5. Data Collection Procedure
To identify business and system requirements, in depth interview was used . All
documents like registration used by the biomedical department, formats, reports on
equipment inventory and BPR document of the department were reviewed.
3.6. Data Analysis Procedure

UML techniques were used to model the analysis and design of the new proposed
system. For the analysis part use case diagram and narrate use cases were used to
identify the system boundary and the processes in the system. Activity diagram
was also used in the analysis part of the project. Class diagram and sequence
diagram were used in the design. The UML techniques are more related with OO
analysis and design methodology and the investigator has better knowledge to use
it. The tools used to sketch the models and user interface prototype were Visio
and White Star UML.
3.7. Date Quality Management

Various efforts were made to assure the analyzed information quality, by referring
a different medical equipment standard and guidelines. To achieve optimum system
requirement and user satisfaction, users were involved in each verification process of
the design.
3.8. Implementation
In the prototype implementation of the project, the investigator used HTML to
develop the user interface of client side web page. PHP was used to write the
code that connects the web page and the relational database which is created using
20
MySQL. The investigator used these coding and application because she has more
acquaintance write them.
3.9. Operational Definitions
Health technology: The application of organized knowledge and skills in the form
of devices, medicines, vaccines, procedures and systems developed to solve a
health problem and improve quality of life. It is used interchangeably with
healthcare technology.
Medical device: An article, instrument, apparatus or machine that is used in the
prevention, diagnosis or treatment of illness or disease, or for detecting,
measuring, restoring, correcting or modifying the structure or function of the body
for some health purpose. Typically, the purpose of a medical device is not
achieved by pharmacological, immunological or metabolic means.
Medical equipment: Medical devices requiring calibration, maintenance, repair,
user training, and decommissioning – activities usually managed by clinical
engineers. Medical equipment is used for the specific purposes of diagnosis and
treatment of disease or rehabilitation following disease or injury; it can be used
either alone or in combination with any accessory, consumable, or other piece of
medical equipment. Medical equipment excludes implantable, disposable or single-
use medical devices(4).
3.10. Ethical Clearance

Ethical clearance to conduct the project was obtained from the school of Public
Health Research and Ethical Committee of Addis Ababa University. Permission
was obtained from the Dire Dawa Health Bureau in written form and from all
departments involved in the project, the consent was obtain verbally. This
informed consent from each subject was obtained after clear explanation about the
purpose of the project made.
21
Chapter Four
4. Discussion of Result
4.1. Introduction
The implementer of this project has been using an object oriented modeling
methodology and iterative process model to analyze, design and implement the
project. To design and develop an information system it is important to have a
detailed understanding of the existing system. There are different techniques
available for identifying the system requirements. As mentioned in the
methodology the system requirement was identified and analyzed using UML
modeling technique. The information about the existing system was collected using
in depth interview and document review. In this chapter the requirements analysis
and design of the system will be presented.
4.2. System Analysis

4.2.1. Current System
The investigator tried to review the current system of the organization, in such
way that makes it simple to identify the gaps. The findings organized under six
main subtitles, the existing hardware, software, network, people, data and
procedure/ management.
4.2.1.1. Hardware
In each health facility and at regional health bureau there is at least one idle
desktop computer which is functional. In addition to this, the organization has
financial resource which can make the health facilities and the regional health
bureau equipped with necessary additional hardware. The main problem is that
there is no specific requirement of hardware stated previously in the organization.
Moreover, there is no structural design for the medical equipment information
management system.
22
Table 4.1: Hardware Inventory of the Existing System
S. Location Quant Type and RAM Hard Processer Purpose

no ity model disk
of computer
1 Biomedical 1 Dell 4GB 500 32bit Intel R Office purpose
Department OptiPlex GB Core (tm)
700 cori3 CUP
2.53GHz
1 Toshiba 4GB 500 32 bit ME Inventory \
Satellite GB Record
C55-b-896
2 Dilchora 17 HP 2GB 500 32bit, -Office Purpose
Hospital GB 3.2GHz -Patient Medical
Record Purpose
3 Sabiyan 15 HP 2GB 500 32bit, Office Purpose
Hospital GB 3.2GHz -Patient Medical
Record Purpose
4 Gendkore 10 HP 2GB 500 32bit, Office Purpose
H. C. GB 3.2GHz -Patient Medical
Record Purpose
4.2.1.2. Software
Currently the organization is not using any specific software application related
to the medical equipment information management, but the organization has
plans to get a software application to help them in the management of medical
equipment in the near feature (interveiw,1).
23
4.2.1.3. Network
The regional health bureau and the corresponding public health facilities are not
interconnected by the network, but almost all urban public health facilities and the
regional health bureau have a broadband internet connection within their
organization. RHB internet capacity is 4GB. Dilchora hospital has 2GB internet
connection. Sabiyan hospital has 2GB and Gendkore health center has 2GB. This
internet availability can be valid opportunity in the implementation of web based
medical equipment information management system.
4.2.1.4. People
Under the regional health bureau curative and rehabilitative core process, there are
two biomedical engineers and two biomedical technicians in the pharmaceutical
and medical equipment management and maintenance case team. They are
responsible for the management and maintenance of medical equipment available
in all public health facilities within the region. They use the workshop of
Dilchora hospital as maintenance center. All the professionals have at least basic
computer application skills.
4.2.1.5. Data / Process
As the interviews and document reviews show, there is no enough documentation

on medical equipment performance, maintenance, down time, and replacement,
especially after the equipment were issued to the facilities. In 2003EFY a general
inventory was done by the Regional Health bureau for the purpose of knowing the
available equipment type in the region. The second inventory is done in
2007EFY. The inventory formats being used includes the following information,
inventory number, type of equipment, manufacturer, model, serial no., country of origin,
year of manufacturer, power requirement, spare part availability, manual available,
location, and equipment user. Due to absence of organized document preventive
maintenance was not being done as per the equipment manufacturer standard.
There are no records kept about the corrective maintenance being done.
24
Generally, the existing documentation system does not give complete information
about equipment current situation, nor does it give previous equipment life history.
4.2.1.6. Procedure
Figure 1 shows the organizational structure of the regional health bureau. It points
the exact position of the biomedical case team, who is responsible in the overall
management of medical equipment in the region. The process of managing medical
equipment among the facilities of the region is limited only on the stores, in
which the information on medical equipment received or issued by the stores are
recorded using model 19 and model 22.
4.2.1.7. Management
4.2.1.7.1. Vision of the Department
To see a healthy, productive, and prosperous Dire Dawa society.
4.2.1.7.2. Mission of the Department
To reduce morbidity, mortality, and disability thought providing an express and
qualitative curative and rehabilitative health service in collaboration with
Stakeholder (37).
4.2.1.7.3. Responsibility of the Department
The responsibilities of the department are planning, procure, distribute drugs and
medical supplies including equipment and control over all management throughout
the region(37).
4.2.1.7.4. Job Description of the Professionals
The biomedical professionals are responsible in performing the following
tasks(37).
- Planning on the usage and maintenance process of medical equipment.
- Requesting spare part procurement for maintenance service.
- Provide on-site maintenance service throughout the public facilities.
- Assist with an equipment specification plan.
- Provide training for health professionals on equipment usage.
- Reporting about medical equipment needed to be replaced or discarded to
the responsible body.
25
- Preform annual medical equipment inventory.
- Make general performance report.
4.2.1.7.5. Communication
The biomedical department has direct communication way with the facilities.
Facilities make requests for corrective maintenance or consultancy verbally to the
department.
Organizational Structure
Dire Dawa Administrative Health Bureau
DPCP CRCP Regulatory Finance HR Plan & Program
Blood Regional Quality Pharmaceutical &

Bank Lab service Medical Equipment
Control Mgt & Maintenance
Biomedical Pharmacy
Case Team Case Team
Figure 4.1: The Organizational Structure Of Dire Dawa Administrative

Health Bureau
Generally, the existing system does not have a preventive maintenance tracing
mechanism, there is no records on corrective maintenance done and spare part
used. The corrective maintenance work order request made verbally to the central
biomedical department. The business process of the existing system is limited only
to the receiving and issuing process of the pharmacy store. The central biomedical
department has no controlling mechanism over the performance and maintenance
of the medical equipment. Therefore, to manage the medical equipment
performance, maintenance, down time, and on time replacement of equipment, it is
important to have strong medical equipment information management system which
26
keeps records and provide reports about the medical equipment in all public
health facilities of the region.
4.2.2. Proposed System
The proposed system is applicable to the health facility and central Biomedical
department. It will be implemented using client/ server based system architecture.
A computerized equipment maintenance system might include equipment inventory
module, spare part inventory module, and maintenance module in addition to other
optional modules (3). Hospital medical equipment management guide has stated
nine operational standards for medical equipment management. From these nine
standards the three indicate that a hospital must have a paper based or computer
based equipment and spare parts inventory management system and equipment
history file (11). Depending on these documents and from the assessment findings
of the current system, the investigator decided to make the new Medical
Equipment Information Management System (MEIMS) to include medical equipment
registry, spare part registry, preventive maintenance record, corrective maintenance
record, and general report modules.
27
4.2.2.1. Context Diagram for the New MEIMS
Figure 2 present the context diagram of the proposed system, which is a top level
view of the information system that shows the system’s boundaries and scope. It
also shows how the system interfaces with the outside world.
ADMINISTRATOR
Request C.M Order

FACILITY USER
Create Setup
Report
Report
0 Equip. Information
Spare Part Report

MANAGING
MEDICAL P.M. Notification
EQUIPMENT
Equipment Report
Message
Spare Part C.M. Record

BIOMEDICAL BIOMEDICAL
Information
DEPARTMENT HEAD TECHNICIAN
P.M. Record
Figure 4.2: Context diagram for Medical Equipment Information

Management System
28
4.2.3. Stakeholders
Stakeholders are individuals or organizations that could influence or be influenced
positively or negatively by medical equipment information management system.
Table 4.2: List of stakeholders and their roles and responsibilities

S.n Stack holders Role and Responsibilities
1 System -Responsible for creating and updating user account , organizational
Administrator setup, Manufacturer setup, supplier setup and department setup.
2 Facility focal -Responsible for medical equipment information registry
Person -Responsible for sending a request for corrective maintenance work
order
-Responsible for requesting the system to generate reports and use the
report at the point of service.
3 Biomedical -Responsible in recording preventive and corrective maintenance details.
Technician - Responsible for registering spare part information.
- Responsible for generating reports and use the report in the
improvement of service provision.
4 Biomedical -Responsible for generating equipment report.
department - Responsible for disseminating the report for decision making bodies.
head - Responsible for facilitating overall activities in the biomedical
department.
5 Health - Responsible for providing appropriate information about medical
Professional equipment performance and incidence
6 Health - Responsible for providing administrative and infrastructure need
Facility - Responsible for interpreting reports and make a decision at the
Management facility level
7 Curative -Responsible for controlling overall medical equipment management
Department information system at the regional level
Head -Interpret and use the report for decision making purpose at regional
level
29
4.2.4. System Analysis Models
The following use cases have been identified from the new proposed system
specification.
- Login
- Create an account
- Register medical equipment
- Register spare parts
- Produce preventive maintenance schedule
- Record preventive maintenance Information
- Complete corrective maintenance work order
- Record corrective maintenance record
- Generate standard report
o Corrective Maintenance Report
o Preventive maintenance Report
o Medical equipment Report
o Spare Part Report
4.2.4.1. Use Case Diagram
To create use case diagram for the proposed system, the investigator tries to
identify what process should be included in the system, depending on the
document reviewed and existing system assessment findings. Then she describes
how many use cases should all the process be presented and identifies if there is
an association between any of the use cases. The investigator identifies the
primary and the secondary actors for each use case and relates each actor with its
corresponding use cases.
During identifying actors in the system use case, actors who are responsible in
recording medical equipment, requesting corrective maintenance work order and
administrator are not available in the existing organizational situation. The second
point discovered in this process is, the system boundary overlaps somehow with
the pharmacy store process.
30
The following diagram shows all the use cases identified from medical equipment
information management system process. It also shows the actors of the system as
well as the boundary.
System
Login
Administrator Creates SetUp
Setup Supplier
Setup User
Setup Facility
Setup Manufacturer
Facility Focal Person
Biomedical Technician
Record Medical Equipment
Record SparePart
<<include>>
<<include>>
Notify P.M Schedule
<<extend>> Facility Focal Person
Biomedical Technician Assign Technician
Record P.M Include
Request C.M
Biomedical Department Head

Record C.M
<<include>>
Generate Standard Report
Figure 4.3: System Use Case Diagram for Medical Equipment Information
Management
31
4.2.4.2. Use Case Narrations
The narrations of use cases are used to illustrate each use case or process
identified in a use case diagram. It is very helpful to make the end user to
understand the process of the system. In this case all the processes are narrated
along with its actors, trigger point, the output of the processes and so on. The
sample of the use case narration and activity diagram are presented in the following
figures, the whole document is available in appendix A.
4.2.4.3. Activity Diagram Modeling

The activity diagrams are used to illustrate the process of the system in a
diagrammatic form. It helps to present the process in a sequential order.
The following activity diagram shows all objects within the medical equipment
information management system and their interaction with the system.
32
Use Case ID: UC-03
Use Case Title Register medical equipment
Use case This use case describes the process of registering electronic
Description medical equipment information.
Primary Actor Facility focal person
Trigger The focal person attempts to register medical equipment by selecting
the medical equipment option from system main menu
Pre-Conditions The user is logged in to the system
Post- Medical equipment information is recorded in the system database.
Conditions The equipment is assigned a unique ID.
Main scenario 1.The user selects medical equipment recording menu option;
2.The system displays medical equipment recording form; (Figure
4.21)
3.The user fills the form with equipment information;
4.The user clicks submit button;
5.The system saves the equipment information on the system
database and make the form ready for the next record;
Alternative 4.1. If the user clicks on cancel button;
scenario 5.a. The system return to the main menu;
4.2. If the user clicks on reset button;
5.b. The system clear the input box;
Frequency of About 40 per month
Use
Business Rule
33
Display Main Menu
Select M.E Registry Form
Display M.E Registry Form
Cancel Fill M.E Information Reset
Save
Figure 4.4: Activity diagram for medical equipment registering process
34
4.2. User Interface Prototype
User interface prototype is a model used to simulate the system user interface at
an early stage of the system design. It can be developed using hand drawing or
CASE tool like Visio. It helps to make the end user to test the system at an
early stage and identify the gaps in very low cost and time. It also helps to
communicate ideas between designer, developer, users and stakeholders. The
following sample user interface prototype is developed using Visio presents the
new system, the rest total document is found in Appendix A.
User Interface Prototype ID: UIP-03
Medical Equipment Registery Form

Location
Notification
Facility Department
· It is time for preventive
maintenance, Please click
to check out the list
Equipment Risk High Medium Low
Equipment Code
Classification
Main Menu · There is request from facility
Equipment Warranty expiration DD/ MM/ YY for corrective maintenance,
Medical Equipment Description Please click to check out
Registry Consumable
Spare Part Registry Model Requirement
P.M Record 01 Month
P. M Schedule
C.M Record Serial no.
General Report
Manufacturer User of the Item
Manufacturer Expected Life 01 Month

Address
Supplier Status
Supplier Address Cost
Year Manufactured : Instalation Date DD/MM/YY
Available Manual
Reset Save Cancel
35
4.2.5. System Requirements
Requirement constitute a specification for the new system. It is the starting point
for measuring the performance, accuracy, and completeness of the finished system
before entering the system design. In system analysis, it is important to identify the
functional and Non functional requirement.
4.2.5.1. Functional Requirements
Functional requirement describes the interaction between the system and its users,
and between the system and any other systems which may interact with the
system by supplying or receiving data (38). The high level functional requirements
identified in the new system are listed as follows.
Table 4.3: Functional requirement list
Req. Requirement Description Requirement Ranking
ID Source Mandatory Optional
01 The system should differentiate the UC-01 X

ordinary user and administrator
02 The system should enable authenticated UC-01 X
user to log in to the application
03 The system should enable the user to UC-03 X
register medical equipment
information
04 The system should enable the user UC-04 X
register spare part information
05 The system should provide preventive UC-05 X

maintenance schedule notification
record preventive maintenance
information
07 The system should allow the user to UC-08 X
send
36
corrective maintenance request
record corrective maintenance
information
user to edit and delete records
10 The system should generate all types of UC-10 X
standard reports
11 The system should enable the UC-02 X
administrator to create, delete, update user
setup
12 The system should enable the administrator UC-02 X
to create, delete, update facilities setup
to create, delete, update Manufacturer
setup
to create, delete, update Supplier setup
37
4.2.5.2. Non functional Requirement
Non functional requirement describes how well the system supports the functional
requirement. It describes not what the software will do, but how the software will
do it (38). The new system is expected to include the following nonfunctional
requirement, performance criteria, the reliability requirement, security consideration,
interface requirement, and error handling.
Table 4.4: Non Functional requirement list
01 The system shall provide 8 hours per day Interview(1,2) X

service
02 The system shall uses English language All User X
interface
03 The system shall provide error message (Figure 4.31) X
Whenever the user attempts to enter invalid
data
04 The system shall provide notification message (Figure 4.21) X
whenever the user leave crucial text box empty
05 The mean time between failure must be 3 Reference No. X
month 39
06 The average user learning time must be less Reference No. X
than 1 day 39
07 The system shall be available 99.99% of Reference No. X
time 39
08 The system shall be modifiable Reference No. X
39
09 The system shall use client server system Reference No. X
architecture 39
38
4.3. System Design Models
4.3.1. System Class Diagram
To design MEIMS the investigator uses class and sequence diagrams. The class
diagram uses to present the system classes (object), their attributes, association
between classes, attribute type, class methods (what a class can do), navigability of
class, and dependency between classes. The investigator tries to identify all the
classes by taking all noun words from the narrated use cases defined previously
and differentiate the words that should not be a class. After identifying all
possible classes, the second step was looking for the association between each
class. The class identified were, ‘UserAccount’ class, which is inherited by ‘User’
and ‘Administrator’ class. ‘Department’, ‘Supplier’, ‘Facility’ and ‘Manufacturer’
classes are managed by the administrator class. The class ‘Registration’ captures
the information of ‘Equipment’, ‘Sparepart’, ‘PreventiveMaintenance’, and
‘CorrectiveMaintenance’ classes. The rest of the interface class ‘Report’ and class
‘C.Mworkorder’ are performed by the class ‘User’. Depending on the existing
system document and literature reviewed, the attributes of each class were
identified by their type. The attributes are used as an identity for a class. The
functions of all classes were identified as well as the parameter they get or set
using the narrative use cases as a reference.
39
0..* UserAccount Report
+UserName:string
-UserPassword: 0..* +GenerateReport()
Administrator +UserT ype:string Requests
+Facility:string C.M.WorkOrder
+CreateUserAccount(UserName, UserPassword)()
Manages +SetDepartmentsetup(Code, Name)() +GetUserAccount( Name, Password)() +WorkOrderNo:String
1 +SetFacilitysetup(Code, Name)() +Problem:String
+SetSuppliersetup(Code, Name)() +ProblemDesc:String
1 +SetManufacturersetup(Code, Name)() +AssignedT ech:String
1 Makes
1
1 0..* +OrderDate:Date
User
1 +CM.WorkCopmlete(C.MCode, Failure )()
Manages 1
Manages +CompleteRegistration(RegiNo, Date)()
0..* +RequestWorkOrder(OrderNo, Problem)() CorrectiveMaintenance
0..*
+SelectReportOption(Facility,Equipment)()
Manages Manufacturer +C.MCode:Integer
Department 1 +Failure:String
+ManufCode:String Captures
+DepartCode:String +Cause:String
Manages +ManufName:String Completes 0..*
+DepartName:String +T imeRequired:Integer
+ManufT el:String
+ActionT aken:String
+GetDepartSetup(Code, Name)() +ManufEmail:String
1 +CompleteT echni:string
0..*
+GetManufSetup(Code, Name)() +CompleteDate:Date
1
Registration +Sparepart1:String
1 +Sparepart2:String
+RegistrationNo:Integer
0..* +RegistrationDate:Date +AddC.M.Record(C.MCode, Failure)()
0..* +RegistrationT ime:time
Supplier
+CaptureEquipmentRecord(EquipCode, EquipDesc)() PreventiveMenttenance
+SupplierCode:String Facility
+CaptureSparePartRecord(SpareCode, SpareDesc)() 1
Captures +P.MCode:Integer
+SupplierName:String +FacilityCode:String +CaptureC.MRecord(C.MCode, FailureT ype)() 0..* +P.MDone:String
+SupplierCount:String +FacilityName:String Includes +CaptureP.MRecord(P.MCode, PMDone)()
+SupplierT el:String +P.MDescription:String
+FacilityAddress:Srting
+SupplierEmail:String +T imeReq:String
1 1
+GetFacilitySetup(Code, Name)() +Sparepart1:String
+GetSupplierSetup(Code, Name)() +Sparepart2:String
1 Captures
1 Captures +DateComplete:Date
+Includes +T echComplete:String
Includes
0..* 0..* +AddP.MRecord(P.MCode, P.MDone)()
1
Includes Equipment
SparePart
+EquipCode:String
1 +SpareCode:String
+EquipDesc:String
+Model:String +SpareDesc:String
1 +SerialNo:Integer +Model:String
+ManufY ear:Date +Location:String
1 +RiskClass:String +ManufaY ear:Integer
+WarrantyExpiry:Date +UseFor:String
+Consumable:String +Cost:Integer
+PMSchedule:Integer +Date:Date
+ExpectedLife:Integer +AddSparepart(SpareCode, SpareDesc)()
+Status:String
+Cost:Integer
+InstaletionDate:Date
+Manual:String
+EquipmentGetRegistred(RegiNo,RegiDate)()
Figure 4.5: Class Diagram for Medical Equipment Information Management System
40
4.3.2. Sequence Diagrams
Depending on the class diagram, the use cases, and the objects identified
previously, the sequence diagrams were used to clarify the flow of process within
the system. Each method of a class was presented with its parameters to be
passed. The sequence diagram of the system presents all objects found in each use
case model of the system and their interaction with the system in a sequential
order of their occurrence. The following figure shows a sample of sequence
diagram for the system, the whole document is available in appendix A.
User RegistryInterface RegistrationController EquipmentRegistration

SelectInterface
ActivateInterface()
DisplayEquipmentRegi()
EnterEqipment(Code,Descr)
GetEquipment()(Code, Desc)
SetEquipment()(Code, Descr)
AcknowlegeP.MRecord
Figure 4.6 : Sequence diagram for the process of registering medical

equipment
41
4.3.3. System Architecture
System architecture translates the logical design of an information system into a
physical structure (21). This medical equipment information management system is
designed to have a three tiers Client/Server architecture. The client/server
architecture refers to systems that divide processing between one or more
networked clients and a central server. In this system, the client handles the entire
user interface, including data entry, data query, and screen presentation logic. The
server stores the data and provides data access and database management functions.
Application logic is divided in some manner between the server and the clients.
In a client/server interaction, the client submits a request for information from the
server, which carries out the operation and responds to the client. Only the request
and the result are transmitted across the network.
The investigator proposed the Client/Server system architecture because, the
Client/Server is cost effective in large scale networks, flexible, and scalable (21).
The following diagram represents the planed system architecture design for medical
equipment information management system.
42
Login Page
Setups creating Pages
Medical Equip. Recording Page
Spare Part Registry Page
User Interface P.M Notification Page
P.M Recording Page
C.M Requesting Page
C.M Recording Page
Report Option Selecting Page
Presentation Layer Reporting Interface
Record Inserting Process
Record Retrieving Process

Logic Access
Work Order Sending Process
Schedule Notification
Process
Application Layer Report Generating Process
Equipment Registry
Spare Part Registry
P.M Record
P.M Notification Record

Date Base
C.M Record
User Account Record
Facility Record
Server
Department Record
Manufacturer Record
Figure 4.7: MEIMS Architecture
Supplier Record
43
4.4. Prototype Implementation
The implementation of MEIMS is done in three parts, the presentation layer, Database
layer, and the middle layer. The user interface/ presentation part is implemented using
HTML and CSS coding. The database is developed using MySQL database management
system and the middleware, which connects the user interface and the database, is
implemented using PHP. The following snapshots present some of the user interface of
the system.
4.4.1. Presentation Layer

4.4.1.1. Medical Equipment Registry Form
Medical Equipment Registry allows the user to register new medical equipment
information into the system. To open the registry form, it only needs to select
medical equipment option from the main menu. It contains all information about a
specific equipment need to be capture. The following is the sample of the form
all the document is available in appendix A.
Figure 4.8: Medical Equipment Registry Form
44
4.4.1.2. Usability Testing for User Interface
Usability Testing aids, to identify whether the system satisfies the requirements of
its end users. In the case of MEIMS design, usability testing is done initially by
using the user interface to identify the gaps of the requirement need to be
achieved by the system as early as possible. The testing is done by introducing
closed ended questions to the end user of the organization. It participates five
users after explaining the use of the test and how to use the user interface. This
test is the initial test to be done in the first iteration of the system development
process and which should be continued in each iteration until the system achieves
the specified requirement. The following table shows the summarized results of the
test done by the five participants.
Table 4.5: User Interface Test Result
S. Test Questions Strongly Disagr Undecide Agre Strongly
no Disagree ee d e Agree
1 The interfaces are attractive 2 3
2 I like the color of the 3 2
interface
3 The font of the interface are 4 1
Good
4 The sequence of the interface is 2 3
clear
5 All important content 2 3
addressed well
6 There is too much inconsistency 4 1
in the system interface
7 I found the interfaces are very 4 1
cumbersome to use
8 The interfaces are easy to 1 4
understand
9 I need more time to learn it 2 3
10 There is unnecessary content 5
available in the interface
45
Generally, the users agree with most parts of the interface, but still there are some
more need of improvement to achieve user requirements. The point the user not
satisfied at being attractiveness, sequence, consistency and the learnability of the
user interface. Therefor it should be reviewed again to identify the specific gaps
and put a solution.
4.4.2. Database Layer

4.4.2.1. Database Model
Depending on previously designed class diagram, data storage area is created
using tables in the database. All fields of table are identified and the
corresponding primary key within each table. The primary key is used to identify
a specific record within a table. To create a simple, flexible, and free of data
redundancy, normalization is done on the tables. “Normalization is the process of
creating tables designs by assigning specific fields or attributes for each table in
the database” (21). After passing through a different normalization stage of the
tables, the database is modeled using relational model. The relational model uses
a foreign key to establish relationships between tables and form an overall data
structure. The relational database is used because it is well suited to client/server
computing(21). The created tables include Equipment Registry, Spare Part, Corrective
Maintenance, Preventive Maintenance, Work Order, Equipment list, Facility,
Department, Manufacturer, Supplier, User Account tables.
4.4.2.2. Physical Storage

The physical storage involves a physical record or block, that can be handled by
the operating system at a time. The storage can be located in different areas. In
the case of this system the storage is located on a web based. A physical record
can contain many logical records, which is a set of field values that describes a
single record in a table regardless of how or where the data is stored.
The following figure 4.9 illustrates the overall storage tables along with their
relationships. The details of physical data model of MEIMS database are
presented by figure 4.10.
46
Manufacturer
Supplier 1
∞ Workorder
1 Supply
∞
Supply Has
Make
∞ 1
∞ 1
Has 1
∞ Utilize 1 ∞ Facility
Spareregistery equipregistery
1 1
1 1
Incorporate
Need
Need ∞
Has
department
∞
∞
CorrectiveM
preventiveM
1
1
Useraccount
Get
∞
equipmentlist
Figure 4.9: Overall storage tables and their relationships to each other
47
Figure 4.10: The physical Database Model of MEIMS
48
4.4.3. Middle Layer
To connect the user interfaces and the database created, PHP codes are used that
embedding in the HTML. The following snapshot presents the sample of this
cods.
Figure 4.10: Sample of PHP Cods
49
Chapter Five
5. Conclusions And Recommendations
5.1. Conclusions
MEIMS is a system that records all the information on medical equipment
available in the piloted urban public health facilities. The information includes the
life history of the medical equipment, preventive and corrective maintenance of the
equipment, the cost for the maintenance and records for the spare part availability.
The system supports following the performance of specific equipment and its life
cost. It also provides an information for planning and decision making in
management.
This project represents the first step towards developing MEIMS. As it follows an
iterative process, it shows the first blueprint of the iteration that will be improved
through the cyclic development process of the project until it satisfies the user of
the system.
In the process of analysis and design this system, the investigator recognizes that
the boundary of the system somehow overlaps with the system of pharmacy store,
which captures the information of medical equipment at initial. The existing system
documentation is not well organized and complete, that makes the investigator
depends on literature to design the system. A manual documentation system is a
base for implementing the new system. It is identified that the system may need
additional human resource specially at the health facilities, who will be
responsible in implementing the system. There are some opportunities identified
like computer hardware and internet access at the central office and the piloted
three facilities, though they need to be scaled up in capacity. In designing
process, the security issues and hardware design were not well addressed by this
project. The user interface of the system needs to be improved according to the
test result identified.
Generally, this project does not show the final product of the system, rather
provides system prototype for further continuous evaluation and development along
with the user feedback input.
50
5.2. Recommendations
Dire Dawa Health Bureau

The health bureau is recommended to initiate the revision of the pharmacy store
computer system by;
- Reinforcing the supporting stakeholder to include medical equipment
information into the system and,
- Scale up the system to support the management of equipment performance
after the installation.
The bureau is recommended to strengthen the documentation system centrally and
at the facility level by;
- Including all important information in the documentation and,
- Reinforcing the biomedical technicians to keep records of preventive and
corrective maintenance, during receiving and handover equipment, and spare
part used for maintenance.
- The organization should plan to assign one responsible person at the facility
level to organize and manage medical equipment information
In addition to the fulfillment of important infrastructure for the implementation of
web base MEIMS, it is recommended to scale up the existing computer hardware
to be used by the system as follows,
For front end web server
Processor RAM Hardware
64bit, four core, 2.5 GHz 8GB 80GB
For application server
64bit, four core, 2.5 GHz 8GB/16GB 80GB
For SQL server tier
64bit, four core, 2.5 GHz 16GB 100GB
51
Ministry of health
The ministry of health should encourage the regional health bureau to implement
MEIMS by identifying and coordinating with stakeholders to support the region.
Researcher
The investigator would like to recommend future researcher to;
- Put their effort on the analyzing and design a system which integrates the
pharmacy store computer system with the medical equipment information
system
- Implement this system by reviewing and addressing the security issue, the
hardware design and usability testing of the system.
Addis Ababa University School of Information Science and School of Public Health
The investigator would like to recommend the school to initiate the ministry of
health and regional health bureaus on the introduction of information technology
in health by proving a short term training or workshops to build their attitude
toward technology.
52
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Term “Medical Device” The Global Harmonization Task Force, May 20, 2005.
2. WHO,” Introduction to medical equipment inventory management ” WHO
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3. Computerized maintenance management system, World Health Organization,
Press 20 Avenue Appia, 1211 Geneva 27, Switzerland, 2011.
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University
Health System Department of Clinical Engineering, 2010
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engineering. Arlington, Association for the Advancement of Medical
Instrumentation, 2003.
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Devices, June 25, 2012.
9. Afshin Jamshidi, Samira Abbasgholizadeh Rahimi, Daoud Ait-kadi, Angel Ruiz
Bartolome “Medical devices Inspection and Maintenance; A Literature Review”,
Canada, 2014.
10. David Mutia, John Kihiu, Stephen Maranga, “Maintenance management of
medical equipment in hospitals”, Vole 2, No.3, 2012.
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on Developing an Enabling Scientific Equipment Policy in Africa, Ethiopia
Country Study”, Addis Abeba Ethiopia, July 2014.
12. Medical Device Regulation Global overview and guiding principles, WHO 2003
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Ministry of Health Quarterly Health Bulletin, HSDP, Policy and Practice
Information for Action, The Last Lap Towards Millennium Development Goals
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The Performance of the Health sector in EFY 2005”, volume6,Number 1, Page
13, April 2014.
14. FDRE Ministry of health, Ehtiopian Hospital Reform Implementation Guideline,
Volume 2, may 2010.
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Term “Medical Device” The Global Harmonization Task Force, May 20, 2005
16. WHO,” Introduction to medical equipment inventory management ” WHO
Medical device technical series, 2011
17. Andreas Lenel, Caroline Temple-Bird, Willi Kawohl, Manjit Kaur ,“How to
Organize a System of Healthcare Technology Management”, World Health
Organization,2009
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Technology, Clinical Engineering (Principles and Applications in Engineering)”,
CRC, New York, 2003.
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Management System, Everything you need to know about maintenance
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20. Juha-Pekka, “Incremental Method Engineering with Modeling Tools
Theoretical principles and empirical evidence”, Finland, 1998
21. Shelly, Cashman, Rosenblatt, “System Analysis and Design fifth edition”,
USA, 2003
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England, 2004.
23. What is iterative model advantage, disadvantage and when to use it?[Internet]
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advantages-disadvantages-and when-to-use-it/.
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model-advantages-disadvantages-and when-to-use-it/.
25. Kevin Yank, “ PHP & MYSQL: NOVICE TO NINJA 5th edition”, USA, May
2012
26. D.W. DEAN and Dr J.A. RYDER, “ An Equipment Maintenance System”,
Republic of South Africa
27. KALMAN, “KALMAN Equipment Management System”, US, 2015
54
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WWW.advantech.com/healthcare/Technology%20Highlight, March 2013
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Using mobile devices”, South America, 2011
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Interview
1. With Mr. Mahdi Abdel , Pharmaceutical and Medical Equipment Department
Head, March,2015, at Dire Dawa.
2. With Mr. Anteneh Berhanu, Biomedical Staff, March, 2015, at DireDawa.
55
Appendix A
Software Requirement Specification Document
For
Web Based Medical Equipment Information Management
System
56
Chapter One
1.1. Introduction
In delivering the health care service, health professionals use different kinds of
medical equipment to provide quality health care service. Medical equipment is
any instrument, apparatus, implement, machine, appliance, implant, in vitro reagent
or calibrator, software, material or other similar or related article which does not
achieve its primary intended action in or on the human body by pharmacological,
immunological or metabolic means. Medical equipment information management
system used to automate the documentation of all activities relating to medical
equipment. The Biomedical department or clinical engineering department is
responsible in including and excluding medical equipment in the health technology
management program for tests, repairs and maintenance. Appropriate management
of medical equipment ensures safe and effective health service provision. Medical
equipment information management system (MEIMS) used to automate the
documentation of all activities relating to medical equipment. MEIMS incorporates
equipment and spare part inventory modules, maintenance module, and contracts
management module
1.2. Objective
The objective of this project is to design web- based information system for
medical equipment management taking the Dire Dawa administration health bureau
as a case.
1.3. Purpose
This system development provides different functionalities for different individuals.
For the users it may make their work easier, effective and efficient by using
information technology and make them to take one step forward. For the regional
health bureau, it provides a system prototype ready for implementation and may
help policy makers reach a decision regarding health technology.
57
1.4. Scope
This project is limited to the design of a web based medical equipment

information management system and a system prototype thereafter. The project
does not present a complete outstanding system rather it provides first a blueprint
of the initial system development iteration process output. It also includes the
initial user interface prototype testing. The medical equipment included in the
management information system are those instruments, apparatus, machine,
calibrator, materials and vitro reagent used for prevention, diagnosis, treatment and
rehabilitation service provision for a patent, excluding implantable, disposable or
single use medical equipment. The project uses an Object Oriented methodology
as modeling method and the iterative process modeling as a process of analyzing
and designing the system. The technique used in this system analysis and design
are UML modeling techniques. To present the UML models and the user
interfaces prototype of the system Visio and White Star CASE tools are used.
PHP, HTML programming language and MySQL database management system are
used to implement the system software prototype. The system architectural design
is presented using three tire client server system architecture. The hardware
requirement and network design are not included in this project.
58
Chapter Two
2. Functional Requirements
Requirement constitute a specification for the new system. It is the starting point
for measuring the performance, accuracy, and completeness of the finished system
before entering the system design. In system analysis, it is important to identify the
functional and Nonfunctional requirement.
Functional requirement describes the interaction between the system and its users,
and between the system and any other systems which may interact with the
system by supplying or receiving data (38). The high level functional requirements
identified in the new system are listed as follows.
Table2.1 Functional requirement list
01 The system should differentiate the UC-01 X

ordinary user and administrator
user to log in to the application
register medical equipment
information
04 The system should enable the user UC-04 X
register spare part information
05 The system should provide preventive UC-05 X

maintenance schedule notification
record preventive maintenance
information
07 The system should allow the user to UC-08 X
59
send
corrective maintenance request
record corrective maintenance
information
user to edit and delete records
10 The system should generate all types of UC-10 X
standard reports
11 The system should enable the UC-02 X
administrator to create, delete, update user
setup
to create, delete, update facilities setup
to create, delete, update Manufacturer
setup
to create, delete, update Supplier setup
60
Chapter Three
3. Nonfunctional Requirement
Nonfunctional requirement describes how well the system supports the functional
requirement. It describes not what the software will do, but how the software will
do it (38). The new system is expected to include the following nonfunctional
requirement, performance criteria, the reliability requirement, security consideration,
interface requirement, and error handling.
Table 3.1. Non Functional requirement list
01 The system shall provide 8 hours per day Interview(1,2) X

service
02 The system shall uses English language All User X
interface
03 The system shall provide error message Figure 4.31 X
Whenever the user attempts to enter invalid
data
04 The system shall provide notification message Figure 4.21 X
whenever the user leave crucial text box empty
05 The mean time between failure must be 3 Reference No. X
month 39
06 The average user learning time must be less Reference No. X
than 1 day 39
07 The system shall be available 99.99% of Reference No. X
time 39
08 The system shall be modifiable Reference No. X
39
09 The system shall use client server system Reference No. X
architecture 39
61
Chapter Four
4. System Modeling
4.1. System Analysis Models
4.1.1. Use Case Diagram Presentation
System
Login
Administrator Creates SetUp
Setup Supplier
Setup User
Setup Facility
Setup Manufacturer
Facility Focal Person
Biomedical Technician
Record Medical Equipment
Record SparePart
<<include>>
<<include>>
Notify P.M Schedule
<<extend>> Facility Focal Person
Biomedical Technician Assign Technician
Record P.M Include
Request C.M

Record C.M
<<include>>
Generate Standard Report
Figure 4.1: System Use Case Diagram for Medical Equipment Information
Management
62
4.1.2. Use Case Narration and Activity Diagram Presentation
Use Case ID: UC-01

Use Case Title Login
Use case This use case describes the user login process to enter into
Description the system and use other functionalities.
Primary Actors Biomedical technician, Biomedical department head, Facility
focal person, Administrator.
Trigger User tries to access the medical equipment information system
Pre-Conditions The user has authorized user name and password.
Post-Conditions The system displays system main menu screen.
Main scenario 6.User opens the medical equipment information system
screen;
7.The user clicks login button;
8.The system displays login form;
9. The user enters ordinary user name and password and
presses login button;
10. The system displays main menu screen;
Alternative 4.1 If the user enters administrator name and password;
scenario 4.1.a. The system displays Administrator screen;
Frequency of More than 88 per month
Use
Business Rule The system allows only two trials to access the system. If the
user fails to enter valid Username or password, the system
locks for one minute automatically.
63
Display Login page
Cancel Type User Name and Password Reset
Authenticate User
Administrator
Display Administrator Field
Ordinary
User
Display Main Menu Page
Figure 4.2: The activity diagram for login process
64
Use Case ID: UC-02
Use Case Title Create Setup
Use case This use case describes the process of creating setups such as
Description organizational setups.
Primary Actor System Administrator
Trigger The administrator intends to create user setup.
Pre-Conditions The administrator logs into system administrator account
Post-Conditions The system setup User/ Facility / Department / Supplier /
Manufacturer
Main scenario 1. The system displays administrator screen with sub menu
2.The administrator selects User setup option
3.The system displays user setup form
4. The administrator enters the new user information and
clicks save button
5. The system setups new user account
Alternative 2.1 If the administrator selects facility Set up option
scenario 3.a. The system displays facility setup form
4.a. The administrator enters facility information
and clicks save button
5.a. The system create new organizational set up
2.2 If the administrator selects department Set up option
3.b. The system displays department setup form
4.b. The administrator enters department information
and clicks save button
5.b. The system creates new department set up
2.3 If the administrator selects supplier Set up option
3.c. The system displays supplier setup form
4.c. The administrator enters supplier information
and clicks save button;
5.c. The system creates new supplier set up;
2.4 If the administrator selects manufacturer Set up option;
65
3.d. The system displays manufacturer setup form;
4.d. The administrator enters manufacturer information
and clicks save button;
5.d. The system creates new manufacturer set up ;
4.1. If the administrator clicks cancel button ;
5.a. The system returns to the main menu ;
4.2. If the administrator clicks reset button ;
5.b. The system clears the input boxes;
Frequency of Use 4 per month
Business Rule
66
Display Administration Field
Manu
User factu
rer
n
tio
Su
za
pp
ni
lie
Select User Setup
ga
r
Or
Select Manufacturer Setup
Department
Display User Form
Select Organiztional Setup Display Manufacturer Form
Select Supplier Setup
Fill User Account Form
Display Organization Form Fill Manufacturer Form
Select Department Setup Display Supplier Form
Save Cancel
Fill Organization Form Fill Supplier Setup Save Cancel
Display Department Form
Save Cancel Save Cancel

Fill Department Form
Save Cancel
Figure4.3: Activity Diagram for Administration process of MEIMS
67
Use Case ID: UC-03
Use Case Title Register medical equipment
Use case This use case describes the process of registering electronic
Description medical equipment information.
Primary Actor Facility focal person
Trigger The focal person attempts to register medical equipment by selecting
the medical equipment option from system main menu
Pre-Conditions The user is logged in to the system
Post- Medical equipment information is recorded in the system database.
Conditions The equipment is assigned a unique ID.
Main scenario 11. The user selects medical equipment recording menu option;
12. The system displays medical equipment recording form;
(Figure 4.21 )
13. The user fills the form with equipment information;
14. The user clicks submit button;
15. The system saves the equipment information on the system
database and make the form ready for the next record;
scenario 5.a. The system return to the main menu;
Frequency of About 40 per month
Use
Business Rule
68
Display Main Menu
Select M.E Registry Form
Display M.E Registry Form
Cancel Fill M.E Information Reset
Save
Figure 4.4: Activity diagram for medical equipment registering process
69
Use Case ID: UC-04
Use Case Title Register Spare parts
Use case Description This use case describes the process of recording electronic
spare part information.
Primary Actor Biomedical Technician.
Trigger The technician attempts to register spare part by selecting the
spare part recording option from system main menu.
Pre-Conditions The user is logged in to the system.
Post-Conditions The spare part information is recorded in the system
database. The spare part is assigned a unique ID.
Main scenario 1. The user selects spare part recording menu option;
2. The system displays spare part recording
form(Figure4.26);
3. The user fills the form with spare part information;
4. The user clicks submit button;
5. The system save spare part information in the system
database and makes the form ready for the next
record;
Alternative scenario 4.1. If the user clicks on cancel button;
5.a. The system return to the main menu;
Frequency of Use About 30 per month
Business Rule
70
Display Main Menu
Select SparePart Registry Option
Display SparePart Registry Form
Cancel Fill SparePart Information Reset
Save
Figure 4.5: Activity diagram for spare part registration process
71
Use Case ID: UC-05
Use Case Title Produce preventive maintenance schedule.
Use case Description This use case describes the process of producing
electronic preventive maintenance schedule.
Primary Actor The MEIMS
Trigger When time is due for preventive maintenance.
Pre-Conditions The frequency of preventive maintenance schedule of
each equipment is recoded on the equipment database
registration.
Post-Conditions The information of preventive maintenance schedule will
be displayed.
Main scenario 1. The system checks time of preventive maintenance of
equipment from the system database;
2. The system displays preventive maintenance
notification message;
Alternative scenario
Business Rule
72
Display P.M. Notification Message
Assign Technician
Save Update
Figure 4.6: Activity Diagram For Preventive Maintenance Notification Message
Use Case ID: UC-06

Use Case Title Assign Technician.
Use case Description This use case describes the process of assigning technician
for preventive maintenance work.
Primary Actor Biomedical department head.
Trigger When the system displays Preventive maintenance schedule.
Pre-Conditions The frequency of preventive maintenance schedule of each
equipment is recoded on the equipment database registration.
Post-Conditions The system save technician assigned for the specific
preventive maintenance.
Main scenario 1.The user requests detail of the preventive maintenance
schedule;
2.The system displays the list of equipment need preventive
maintenance with their specified location;
3.The user fills the name of the responsible technician and
clicks on save button;
4.The system saves the responsible technician name in the
database;
Alternative scenario No
Business Rule
73
Use Case ID: UC-07
Use Case Title Record preventive maintenance information
Use case This use case describes the process of recording electronic
Description preventive maintenance.
Primary Actor Biomedical technician
Trigger The technician attempts to record preventive Maintenance by
selecting the preventive maintenance recording option from
system main menu.
Post-Conditions The preventive maintenance record is saved in the system
database.
Main scenario 1. The user selects preventive maintenance recording
form options;
2. The system displays preventive maintenance record
form;
3. The user selects the equipment and fills the
preventive maintenance form and clicks on save
button;
4. The system saves the record in the preventive
maintenance database;
scenario
Business Rule No
74
Display Main Menu
Select P.M Record Option
Display P.M. Recording Form
Cancel Fill P.M. Information Reset
Save
Figure 4.7: Activity Diagram for Preventive Maintenance Recording
75
Use Case ID: UC-08
Use Case Title Complete corrective maintenance work order
Use case Description This use case describes the process completing electronic
corrective maintenance work order.
Primary Actor Facilities focal person
Trigger The focal person attempts to fill corrective maintenance
request form by selecting the work order option from system
main menu.
Post-Conditions The corrective maintenance work order is recorded in the
system database.
Main Scenario 1. The user selects corrective maintenance work order
form(Figure4.24);
2. The system displays maintenance work order form;
3. The user fills the work order requests form and click on
save button;
4. The system saves the work order in to the system
database and display work order message;
Business Rule
76
Display Main Menu
Select C.M. Work Order Option
Display C.M Work Order Form
Cancel Fill Work Order Information Reset
Save
Figure 4.8: Activity Diagram For Corrective Maintenance Work Order
77
Use Case ID: UC-09
Use Case Title Record corrective maintenance information
Use case Description This use case describes the process of recording electronic
corrective maintenance.
Primary Actor Biomedical Technician
Trigger The biomedical technician attempts to record corrective
maintenance by selecting the corrective maintenance
recording option from system main menu.
Pre-Conditions The user is logged in to the system .
Post-Conditions The corrective maintenance record is saved in the system
database.
Main Scenario 1. The user selects corrective maintenance recording form
options;
2. The system displays corrective maintenance record
form;
3. The user selects the equipment and fills the corrective
maintenance form and clicks on save button;
4. The system saves the record in the corrective
maintenance database;
5. The user click on print button;
6. The system print out the corrective maintenance
recorded;
Business Rule
78
Display Main Menu
Select C.M Record Option
Display C.M Recording Form
Cancel Fill C.M Information Reset
Save
Figure 4.9: Activity Diagram For Corrective Maintenance information

Recording Process
79
Use Case ID: UC-10
Use Case Title Generate standard report
Use case Description This use case describes the process of producing an electronic
standard report.
Primary Actor Biomedical Department head, Facility focal person,
Biomedical technician, Administrator
Trigger The user attempts to generate report by selecting the report
option from system main menu.
Post-Conditions The system generate reports
Main Scenario 1. The user selects report menu;
2. The system displays report option for the user;
3. The user selects option of the report to be generated
and clicks on generate button;
4. The system generates report from the database on the
selected option;
Alternative scenario 3.1. If the user clicks on export button;
4.a. The system export the report;
3.2. If the user clicks on print button;
4.b. The system print out the report;
3.3. If the user clicks on cancel button;
4.c. The system return to the main menu;
Frequency of Use Minimum 1 per month
Business Rule
80
Display Main Menu
Select Report Type
Display Report Form
Cancel Select Report Option
Generate Report Export Report
Print Report
Figure 4.10: Activity Diagram for generating report
81
4.1.3. User Interface Prototype Presentation
User interface prototype is a model used to simulate the system user interface at
an early stage of the system design. It can be developed using hand drawing or
CASE tool like Visio. It helps to make the end user to test the system at an
early stage and identify the gaps in very low cost and time. It also helps to
communicate ideas between designer, developer, users and stakeholders. The
following user interface prototype is developed using Visio presents the new
system.
User Interface Prototype Id: UIP-01
Log In
User Name Enter User Name
Password Enter Password
Log In Cancel
82
User Interface Prototype Id: UIP -02
System Main Menu
Options
Medical Equipment Registery
Spare Part Registery
Preventive Maintenance Record
Corrective maintenance Record
General Report
Cancel
83
User Interface Prototype Id: UIP 0.3
Medical Equipment Registery Form

Location
Notification
Facility Department
· It is time for preventive
maintenance, Please click
to check out the list
Equipment Risk High Medium Low
Equipment Code
Classification
Main Menu · There is request from facility
Equipment Warranty expiration DD/ MM/ YY for corrective maintenance,
Medical Equipment Description Please click to check out
Registry Consumable
Spare Part Registry Model Requirement
P.M Record 01 Month
P. M Schedule
C.M Record Serial no.
General Report
Manufacturer User of the Item
Manufacturer Expected Life 01 Month

Address
Supplier Status
Supplier Address Cost
Year Manufactured : Instalation Date DD/MM/YY
Available Manual
Reset Save Cancel
84
User Interface Prototype Id:UIP-04
Spare Part Registry Form
Spare Part Code Location Notification
Spare Part Year · It is time for preventive

Main Menu Description Manufactured maintenance, Please click
Medical Equipment to check out the list
Registry Model
Use for
Spare Part Registry
Supplier · There is request from facility
P.M Record
for corrective maintenance,
Cost
C.M Record Please click to check out
Supplier Address
General Report
Manufacturer
Manufacturer
Address
Reset Save Cancel
List of Equipment for Preventive Maintenance

No. Item Code Item Description Date Location Assigned Technician
Abebe
Enter Text
Enter Text
Enter Text
Enter Text
Enter Text
Save Print Cancel
85
Date:- DD/MM/YY
Equipment Code ------------------------
Equipment Description -------------------- Facility --------------------- Department -------------------------------
Assigned Technician -------------------------------

Priority of Task ------------------------
Preventive
maintenance done
Description Text
Time required to
01 Month
Complete
Spare part replaced
Spare Part Code Description Cost Quantity

1 Item Name In birr 2
Technician complete the PM Name
Save Print Cancel
86
Corrective Maintenance Work Order Form
/ / / /
EquipmentCode
Equipment Description --------------------------------------- Model ---------------------------------------
Facility--------------------------------------- Department --------------------------------------- Priority of Task ------------------------
Work Order No. 01
Problem
Problem Description
Text
Assigned Technician
Reset Save Cancel
User Interface Prototype Id: UIP-

08
Corrective Maintenance Record
Work Order No. ----------------- Equipment Code ------------------------

Equipment Description ------------------------ Model -----------------------
Facility --------------------- Department ------------------------
Problem --------------------------------------------- Priority of Task ------------------------
Assigned Technician -------------------------------
Equipment failure Time required to complete 01 Month

Was Item repaired Yes No
Cause of failure
If Yes Corrective action taken
Part to be maintained
Incidence caused by the If No reason not maintained
eqiup
Spare part replaced
Spare Part Code Description Cost Quantity

Technician complete the CM Name
Save Print Cancel
87
General Report
Report Options Facility

Main Menu
Medical Equipment Enter Text
Registery Equipment Report

Spare Part Registery Time Duration
Spare Part Report
P.M Record Starting Date To Ending Date
Preventive Maintenance Report
C.M Record
Corrective maintenance Report Manufacturer
General Report
Equipment Type Enter Text
Incidence Report Supplier
Enter Text
Risk Classification
Enter Text
Cancel

Equipment Report
Facility :- Dil-chora Hospital Equipment Risk Classification :- High Date:-----/--------/-----
Manufacturer ------------------
Supplier ------------------
User of the Item ------------------
Sno. Equipment Available Manual

Model Warranty expiration Status Cost
Description
Print Export
88
Spare Part Report
Date:-----/--------/-----
Manufacturer ------------------ Supplier ------------------
Sno. Spare Part

Model Use for Cost Status
Description
8
9
Print Export

Preventive Maintenance Report
Facility :- Dil-chora Hospital Date:-----/--------/-----
Sno. Equipment Preventive Technician

Required Time Assigned Technician Total
Description Maintenance Done Complete Cost
Print Export
89
Corrective Maintenance Report
Facility :- Dil-chora Hospital Equipment Description ------------------------------- Date:- ------------------
Sno. Failure Cuase Action Taken Technician Total

Required Time Expected Life Assigned Technician Complete Cost
Print Export

Equipment Type
Facility :- Dil-chora Hospital Date:-----/--------/-----
Sno. Equipment Quantity

Type
Description
Print Export
90
4.2. System Design Model
The system design models presented using class diagram and Sequence diagram
0..* UserAccount Report

+UserName:string
0..* +GenerateReport()
-UserPassword:
Administrator +UserT ype:string Requests
+Facility:string C.M.WorkOrder
+CreateUserAccount(UserName, UserPassword)()
Manages +SetDepartmentsetup(Code, Name)() +GetUserAccount( Name, Password)() +WorkOrderNo:String
1 +SetFacilitysetup(Code, Name)() +Problem:String
+SetSuppliersetup(Code, Name)() +ProblemDesc:String
1 +SetManufacturersetup(Code, Name)() +AssignedT ech:String
1 1 Makes +OrderDate:Date
1 0..*
User
1 +CM.WorkCopmlete(C.MCode, Failure )()
Manages 1
Manages +CompleteRegistration(RegiNo, Date)()
0..* +RequestWorkOrder(OrderNo, Problem)() CorrectiveMaintenance
0..*
+SelectReportOption(Facility,Equipment)()
Manages Manufacturer +C.MCode:Integer
Department 1 +Failure:String
+ManufCode:String Captures
+DepartCode:String +Cause:String
Manages +ManufName:String Completes 0..*
+DepartName:String +T imeRequired:Integer
+ManufT el:String
+ActionT aken:String
+GetDepartSetup(Code, Name)() +ManufEmail:String
1 +CompleteT echni:string
0..*
+GetManufSetup(Code, Name)() +CompleteDate:Date
1
Registration +Sparepart1:String
1 +Sparepart2:String
+RegistrationNo:Integer
0..* +RegistrationDate:Date +AddC.M.Record(C.MCode, Failure)()
0..* +RegistrationT ime:time
Supplier
+CaptureEquipmentRecord(EquipCode, EquipDesc)() PreventiveMenttenance
+SupplierCode:String Facility
+CaptureSparePartRecord(SpareCode, SpareDesc)() 1
Captures +P.MCode:Integer
+SupplierName:String +FacilityCode:String +CaptureC.MRecord(C.MCode, FailureT ype)() 0..* +P.MDone:String
+SupplierCount:String +FacilityName:String Includes +CaptureP.MRecord(P.MCode, PMDone)()
+SupplierT el:String +P.MDescription:String
+FacilityAddress:Srting
+SupplierEmail:String +T imeReq:String
1 1
+GetFacilitySetup(Code, Name)() +Sparepart1:String
+GetSupplierSetup(Code, Name)() +Sparepart2:String
1 Captures
1 Captures +DateComplete:Date
+Includes +T echComplete:String
Includes
0..* 0..* +AddP.MRecord(P.MCode, P.MDone)()
1
Includes Equipment
SparePart
+EquipCode:String
1 +SpareCode:String
+EquipDesc:String
+Model:String +SpareDesc:String
1 +SerialNo:Integer +Model:String
+ManufY ear:Date +Location:String
1 +RiskClass:String +ManufaY ear:Integer
+WarrantyExpiry:Date +UseFor:String
+Consumable:String +Cost:Integer
+PMSchedule:Integer +Date:Date
+ExpectedLife:Integer +AddSparepart(SpareCode, SpareDesc)()
+Status:String
+Cost:Integer
+InstaletionDate:Date
+Manual:String
+EquipmentGetRegistred(RegiNo,RegiDate)()
Figure 4.11: Class Diagram for Medical Equipment Information

Management System
91
User LoginInterface LoginController UserAccount
ClickOnLoginButton
ActivateLoginPage()
DisplayLoginPage()
EnterUser(Name,Password)
GetUser(Name, Password)
VerifyUser(Name,Password)
Display()Mainpage
Acknowledge
Invalid Data ()(Name Password)
Figure 4.12: Sequence diagram for login process
92
Administrator SetupInterface SetupController SetupFile
SelectSetupForm
ActivateSetupForm()
DispalyForm()
EnterUser(Name,Password)
ConfirmPassword
ClickSetButton
GetUserAccount(Name, Password)
SetUserAccount()(Name, Password)
AcknowledgeUserAccount
Alternative
EnterFacility(Code,Name)
GetFacilitySetup()(Code, Name)
SetFacilitySetup()(Code, Name)
AcknowledgeFacilitySetup
{OR}
EnterDepartment(Code,Name)
GetDepartmentSetup(Code, Name)
SetDepartment()(Code, Name)
AcknowledgeDepartmentSetup()
{OR}
EnterManufacturer(Code,Name)
GetManufacturerSetup(Code, Name)
SetManufacturer()(Code, Name)
AcknowledgeManufacturerSetup()
{OR}
EnterSupplier(Code,Name)
GetSupplierSetup(Code, Name)
SetSupplier()(Code, Name)
AcknowledgeSupplierSetup
Figure 4.13: Sequence Diagram for the process of creating setup
93
User RegistryInterface RegistrationController EquipmentRegistration
SelectInterface
ActivateInterface()
DisplayEquipmentRegi()
EnterEqipment(Code,Descr)
GetEquipment()(Code, Desc)
SetEquipment()(Code, Descr)
AcknowlegeP.MRecord
Figure 4.14: Sequence diagram for the process of registering medical equipment
User SparePartInterface RegistrationController SparePartRegistration

SelectSparepartInterface ActivateSparepartForm()
DisplaySparepartForm()
EnterSparePart(Code,Descr)
GetSparePart()(Code, Desc)
SetSparePart()(Code, Descr)
AcknowledgeP.MRecord()
Figure 4.15: Sequence diagram for the process of registering spare part
94
P.MController P.MRegistration
User P.M Interface
GetP.MSchedule()(Date)
ExcuiteSchedule()
DisplayPMSchedule(Date, EquipCode)
PMSchedule(Date.EquipCode)
Acknowledge
ClickOnMessage
ActivateForm()
DisplayForm()
AssignTechnician(Name, Id)
GetTechnician()(Name, Id)
SetTechnician()(Name, Id)
Acknowledge
Figure 4.16: Sequence diagram for the P.M notification process
User P.M Interface P.MController P.MRegistration
SelectP.MRecodInterface
Activate() P.MRecodInterface
DisplayP.MPage
FillP.M() (P.Code., Descri)

GetP.MRecord()(Code, Desc)
SetP.MRecord()(Code, Descr)
ACknowledgeP.MRecord
Figure4.17: Sequence diagram for the P.M recording process in the MEIMS
95
User WorkOrderInterface WorkOrderController C.M.Registration
SelectInterface
ActivateOrderForm()
DisplayOrderForm()
FillW.Order(WorkNo.,Descr)
Submit
GetW.Order()(WorkNo., Desc) SetWorkOrder(WrokNo., Descr)
AcknowledgWorkOrder()
DisplayMessage()WorkOrder
Figure4.18: Sequence diagram for the process of requesting C.M work

order
User C.M Interface C.MController C.MRegistration

SelectC.MRecodForm
ActivateForm()
DisplayC.MForm()
FillC.MForm(Code., Failure)
GetC.MRecord()(Code, Failure)
SetC.MRecord(Code, Failure)
AcknowledegeC.MRecord
Figure 4.19: Sequence diagram for the process of recording C.M
96
User ReportInterface ReportController SystemDatabase
SelectInterface
ActivateReportInterface()
DisplayReportPage()
EnterReportOption(FacilityName, Time)
GetReportOption(FacilityName,Time)
GetReport(FacilityName,Time)
AknowledgeReport()
{OR}
GetReportOption(FacilityName)
GetReport(FacilityName,Time)
InvalidReportValue()
DisplayMessage()
Figure 4.20: Sequence diagram for the process of report generating in the
MEIMS
97
4.3. System Prototype Implementation
Medical Equipment Registry
Medical Equipment Registry allows the user to register new medical equipment
information into the system. To open the registry form, it only needs to select
medical equipment option from the main menu. It contains all information about a
specific equipment need to be capture.
Figure 4.21: Medical Equipment Registry Form
98
Preventive maintenance uses to record preventive maintenance done for a specific
equipment and the required time to complete the maintenance work. It also uses
to capture spare part used for maintaining the equipment. The form is opened by
selecting preventive maintenance option from the main menu.
Figure 4.22: Preventive Maintenance Information Recording Form
99
Corrective Maintenance Report
The corrective Maintenance Report form provides an option for the user to select
and generate a report about corrective maintenance done for selected duration,
location and types of equipment.
Figure 4.23: Corrective Maintenance Reporting form
100
Corrective Maintenance Work Order
Corrective maintenance work order form helps the user to request corrective
maintenance for a specific medical equipment from the central biomedical case
team of the region. The user makes the request by selecting the C.M Work Order
option from the main Menu and recording the initial problem of the medical
equipment.
Figure 4.24: Corrective Maintenance Work Ordering Form
101
Figure 4.25: Corrective Maintenance Recording Form
Figure 4.26: Spare Part registry Form
102
Figure 4.27: Medical Equipment Report Form
Figure 4.28: Preventive Maintenance Report Form
103
Figure 4.29: Corrective Maintenance Report Form
Figure 4.30: User Account Creating Form
104
Figure 4.31:Manufacture Setup Creating Form
Figure 4.32: Supplier Setup Creating Form
105
Appendix B:
Requirements Collection Check List
I. Consent Form
School of information science And School of public health
MSc in health informatics program
Consent form
This Interview guide is for a Design of a web-based Information Management System:

The case of Dire Dawa regional health bureau.
To the respondents:
The result of this interview will be utilized for project purpose only. It is hoped that the
outcome of this study will contribute to the improvement of Medical Equipment
Information System Management in Dire Dawa regional health bureau. Therefore, you
are kindly requested to provide genuine response to the questions that follow.
Thank you in advance for your Cooperation”
106
II. Data Collection Tool
In Depth Interview Guide
Data and Process
1. How does the medical equipment inventory process look like?(generally)
____________________________________________________________
2. How are medical equipment problems traced out?
____________________________________________________________
3. How do you control the medical equipment inventory process?
___________________________________________________________
4. How do you monitor equipment status? (life cycle cost, maintenance cost,
equipment replacement)
____________________________________________________________
5. How do you schedule preventive maintenance for the medical equipment? , how
often?
____________________________________________________________
6. How do work orders come to you from facilities for corrective maintenance?
____________________________________________________________
7. Do you have record of corrective maintenance done previously?
____________________________________________________________
8. Can you determine equipment failure trends? How?
___________________________________________________________
107
9. Is there any problem on the existing medical equipment management system?
______________________________________________________________
Report / Communication
10. How do you produce report? How often?
______________________________________________________________
11. For whom do you submit the report?
12. How do you report?
13. Does the organization have communication infrastructure in the implementation

of medical equipment management system? What does it seem?
______________________________________________________________
People
14. How many personals (professionals) involved in the medical equipment
management system? List all
______________________________________________________________
15. How do you identify training needs for the professionals?
_____________________________________________________________
16. Is there any record related to professionals’ performance in the case team?
108
Procedure (Management)
17. What is the organizational structure look like?
_______________________________________________________________
18. Who is responsible on what?
____________________________________________________________
19. How do you plan for medical equipment procurement?
___________________________________________________________
Computer Software
20. Is there any computer software in use for the existing system? What are they?
21. What are the functions of the software?
_________________________________________________________________
22. Does the organization have plan to automate the existing medical equipment
management system?
______________________________________________________________
23. Does the organization ready to support the development of medical equipment
management information system for the biomedical case team? To what extent?
109
Computer Hardware
24. Is there any computer hardware being used in the existing medical equipment
management information system? What are they?
_____________________________________________________________
25. Does the organization ready to fulfill suitable hardware infrastructure in the
development of medical equipment management information system? To what
extent?
Document review Guide

1. Is there any recording process available for medical equipment?
____________________________________________________
2. What types of records are there?
___________________________________________________
3. What does each record include? (information included)
___________________________________________________
4. Is there any structured inventory record format?
___________________________________________________
5. What information does it include?
___________________________________________________
6. Are the records complete?
___________________________________________________
7. What is the mostly missed part in the record? Why?
___________________________________________________
8. Is there problem with the existing reporting format? What is that?
___________________________________________________
9. Who are the user of the formats ?
___________________________________________________
10. Is there a separate record for spare parts?
___________________________________________________
11. What information does it include?
110
Appendix C:
User interface Usability Testing Checklist
1. The interfaces are attractive
Strongly Disagree 1 2 3 4 5 Strongly Agree
2. I like the color of the interface.

1 2 3 4 5
Strongly Disagree Strongly Agree
3. The font of the interface are Good.

1 2 3 4 5
Strongly Disagree Strongly Agree
4. The sequence of the interface is clear.
Strongly Disagree 1 2 3 4 5 Strongly Agree
5. All important content addressed well.
1 2 3 4 5
Strongly Disagree Strongly Agree.
6. There is too much inconsistency in the system interface.
1 2 3 4 5
7. I found the interfaces are very cumbersome to use.
1 2 3 4 5
111
8. The interfaces are easy to understand.
1 2 3 4 5
9. I need more time to learn it.

1 2 3 4 5
10. There is unnecessary content available in the interface.

1 2 3 4 5
112
Declaration
I declare that this project is my original work and has not been presented for a
degree in any other university, any that all sources of materials used for the project
have been acknowledged.
_______________________
Eptisam Mohammed
This project has been submitted for examination with our approval as university
advisors.
__________________ __________________
Dr. Negussie Deyessa Ato Ermias Abebe
Place and Date of submission: Addis Ababa, June 2015
113
Table of Contents
Contents Page
Chapter One ...................................................................................................................... 57
1.1.Introduction ................................................................................................................ 57
1.2.Objective ..................................................................................................................... 57
1.3.Purpose ....................................................................................................................... 57
1.4Scope ............................................................................................................................ 58
Chapter Two...................................................................................................................... 59
2.Functional Requirements ............................................................................................... 59
Chapter Three.................................................................................................................... 61
3.Nonfunctional Requirement ........................................................................................... 61
Chapter Four ..................................................................................................................... 62
4.System Modeling ........................................................................................................... 62
4.1.System Analysis Models ............................................................................................ 62
4.1.1.Use Case Diagram Presentation ............................................................................... 62
4.1.2.Use Case Narration and Activity Diagram Presentation....................................... 63
4.1.3.User Interface Prototype Presentation ..................................................................... 82
4.2. System Design Model ................................................................................................ 91
4.3. System Prototype Implementation ........................................................................... 98
114
List of Tables
Table2.1 Functional requirement list ................................................................................ 59
Table 3.1. Non Functional requirement list .................................................................... 61
List of Figures
Figure 4.1:System Use Case Diagram for Medical Equipment Information .................... 62
Figure 4.2: The activity diagram for login process ...................................................... 64
Figure4.3: Activity Diagram for Administration process of MEIMS.............................. 67
Figure 4.4: Activity diagram for medical equipment registering process ........................ 69
Figure 4.5: Activity diagram for spare part registration process ...................................... 71
Figure 4.6: Activity Diagram For Preventive Maintenance Notification Message .......... 73
Figure 4.7: Activity Diagram for Preventive Maintenance Recording ............................. 75
Figure 4.8: Activity Diagram For Corrective Maintenance Work Order ......................... 77
Figure 4.9: Activity Diagram For Corrective Maintenance information .......................... 79
Figure 4.10: Activity Diagram for generating report ........................................................ 81
Figure 4.11: Class Diagram for Medical Equipment Information .................................... 91
Figure 4.12: Sequence diagram for login process .......................................................... 92
Figure 4.13: Sequence Diagram for the process of creating setup ............................. 93
Figure 4.14: Sequence diagram for the process of registering medical equipment .......... 94
Figure 4.15: Sequence diagram for the process of registering spare part .................. 94
Figure 4.16: Sequence diagram for the P.M notification process ................................ 95
Figure4.17: Sequence diagram for the P.M recording process in the MEIMS ........ 95
Figure4.18: Sequence diagram for the process of requesting C.M work order ................ 96
Figure 4.19: Sequence diagram for the process of recording C.M .............................. 96
Figure 4.20: Sequence diagram for the process of report generating in the MEIMS ...... 97
Figure 4.21: Medical Equipment Registry Form ............................................................ 98
Figure 4.22: Preventive Maintenance Information Recording Form ........................... 99
Figure 4.23: Corrective Maintenance Reporting form ................................................. 100
Figure 4.24: Corrective Maintenance Work Ordering Form ..................................... 101
Figure 4.25: Corrective Maintenance Recording Form ................................................ 102
Figure 4.26: Spare Part registry Form............................................................................ 102
115
Figure 4.27: Medical Equipment Report Form .............................................................. 103
Figure 4.28: Preventive Maintenance Report Form ....................................................... 103
Figure 4.29: Corrective Maintenance Report Form ....................................................... 104
Figure 4.30: User Account Creating Form ................................................................... 104
Figure 4.31:Manufacture Setup Creating Form .............................................................. 105
Figure 4.32: Supplier Setup Creating Form ................................................................... 105
List of Use Cases
Use Case ID:UC-01 .......................................................................................................... 63

Use Case ID:UC-02 .......................................................................................................... 65
Use Case ID:UC-03 .......................................................................................................... 68
Use Case ID:UC-04 .......................................................................................................... 70
Use Case ID:UC-05 .......................................................................................................... 72
Use Case ID:UC-06 .......................................................................................................... 73
Use Case ID:UC-07 .......................................................................................................... 74
Use Case ID:UC-08 .......................................................................................................... 76
Use Case ID:UC-09 .......................................................................................................... 78
Use Case ID:UC-10 .......................................................................................................... 80
List of User Interface Prototypes

User Interface Prototype Id: UIP-01 ................................................................................. 82
User Interface Prototype Id: UIP -02 ................................................................................ 83
User Interface Prototype Id: UIP 0.3 ................................................................................ 84
User Interface Prototype Id:UIP-04 .................................................................................. 85
User Interface Prototype Id: UIP-08 ................................................................................. 87
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ADDIS ABABA UNIVERSITY

SCHOOL OF INFORMATION SCIENCE

Web- Based Medical Equipment Information Management

Addis Ababa, Ethiopia

Web- Based Medical Equipment Information Management

A Project Submitted to the School of Information Science and

Addis Ababa, Ethiopia

Web- Based Medical Equipment Information Management

Name and Signature of Members of the Examining Board

Examiner Signature Date

Examiner Signature Date

Advisor Signature Date

Advisor Signature Date

2.3.4.Management Information System of Medical Equipment using Mobile Devices ... 15

2.3.5.Medical Equipment Management System (MEMS) ................................................ 16

2.3.8.EMIS for Fleet Management ................................................................................ 17

2.3.9.ECRI-AIMS Hospital Equipment Management System ....................................... 17

2.3.10.PTI/APWA Equipment Management Information System ................................. 18

2.3.11Medical Equipment Workflow Management System ............................................. 18

3.2.Study Design .............................................................................................................. 19

3.3.Study Population ........................................................................................................ 19

3.4.Sampling Method ....................................................................................................... 20

3.5.Data Collection Procedure ......................................................................................... 20

3.6.Data Analysis Procedure ............................................................................................. 20

3.7.Date Quality Management ........................................................................................ 20

3.10.Ethical Clearance ...................................................................................................... 21

4.2.System Analysis .......................................................................................................... 22

4.2.2.1.Context Diagram for the New MEIMS ............................................................ 28

4.2.4.System Analysis Models ......................................................................................... 30

4.2.4.1.Use Case Diagram................................................................................................. 30

4.3.1.System Class Diagram ............................................................................................. 39

4.3.2.Sequence Diagrams .................................................................................................. 41

4.3.3.System Architecture ................................................................................................. 42

4.4.Prototype Implementation .......................................................................................... 44

4.4.1.Presentation Layer .................................................................................................. 44

4.4.1.1.Medical Equipment Registry Form ..................................................................... 44

4.4.2.1. Database Model ................................................................................................... 46

Table 4.1: Hardware Inventory of the Existing System ................................................. 23

List of Use Cases

Use Case ID: UC-03 ......................................................................................................... 33

List of User Interfaces

User Interface Prototype ID: UIP-03 ................................................................................ 35

AMT Active Management Technology

BPR Business Process Reengineering

CASE Computer Aided System Engineering

CED Clinical Engineering Department

CRCP Curative and Rehabilitative Core Process

DFD Data Flow Diagram

DPCP Disease Prevention Core Process

EFY Ethiopian Fiscal Year

EMIS Equipment Management Information System

FDA Food and Drug Administration

FMoH Federal Ministry of Health

GHTF Global Harmonization Task Force

HSDP Health Sector Development Program

HTML Hyper Text Markup Language

ISD Information System Development

ITEA Information Technology for European Advancement

KEMS KALMAN Equipment Management System

MEIMS Medical Equipment Information Management System